Quality appraisal of antibiotic consumption in the community, European Union/European Economic Area, 2009 and 2017

Abstract

Objectives The quality of antibiotic consumption in the community can be assessed using 12 drug-specific quality indicators (DSQIs) developed by the European Surveillance of Antimicrobial Consumption (ESAC) project. We compared quality in 2009 and 2017 in the EU/European Economic Area (EEA) and evaluated the impact of using different DDD values (ATC/DDD indices 2011 and 2019) for the 2009 quality assessment using these DSQIs and a joint scientific opinion (JSO) indicator. Methods We calculated the 12 DSQIs and the JSO indicator for 2017 and for 2009 for EU/EEA countries able to deliver values. For each of the indicators we grouped the 2017 and 2009 indicator values into four quartiles. To evaluate changes in quality between 2009 and 2017, we used the quartile distribution of the 2009 indicator values in 30 EU/EEA countries as benchmarks. In addition, we compared the quality assessment for 2009 using the ATC/DDD indices 2011 and 2019. Results In 2017, a difference in the quality of antibiotic consumption in the community between northern and southern EU/EEA countries remained, but also several eastern EU/EEA countries shifted towards lower quality. Quality of antibiotic consumption decreased between 2009 and 2017 in particular indicator values for penicillin, quinolone, relative β-lactam and broad- versus narrow-spectrum antibiotic consumption, and seasonal variation. Using different ATC/DDD indices did not substantially change countries’ ranking based on their DSQI values. Conclusions The quality of antibiotic consumption in the community as measured by the DSQIs further decreased between 2009 and 2017, especially in Southern and Eastern European countries. A continuous effort to improve antibiotic consumption is essential to reduce antibiotic consumption in general and the use of broad-spectrum antibiotics in particular.

Urinary Tract Infections in Elderly Patients: A 10-Year Study on Their Epidemiology and Antibiotic Resistance Based on the WHO Access, Watch, Reserve (AWaRe) Classification

“…Overall, the non-susceptibility rates of elderly isolates were comparable to or somewhat higher than (2–10%) previously reported rates in UTIs in the same geographical region [ 9 ]; higher rates of resistance were mostly seen for nitrofurantoin, fosfomycin, trimethoprim-sulfamethoxazole, all relevant antibiotics in the therapy of uncomplicated UTIs [ 38 ]. Similarly higher rates of resistance were seen for the fluoroquinolones across all analyzed species, a drug group, which has—until recently—been extensively used by primary care physicians in Hungary to treat UTIs [ 39 ]. Interestingly, resistance rates to III.…”

Comparing public attitudes, knowledge, beliefs and behaviours towards antibiotics and antimicrobial resistance in Australia, United Kingdom, and Sweden (2010-2021): A systematic review, meta-analysis, and comparative policy analysis

“…Public awareness interventions that have been evaluated have used mass media to promote rational antibiotic use with mixed results, with some interventions driving improvements in public knowledge [52], others showing no positive effects and one even increasing the likelihood of self-medication and non-rational use [9,27]. After earlier improvements in prescribing rates and levels of AMR in the community from substantial efforts in the previous decades [53], the UK is beginning to have increasing rates of poor quality antibiotic use [31].…”

“…Instead, it is becoming increasingly clear that the rates of antibiotic consumption in the community is an outcome of national and local policies, accepted modes of treatment, the type of health-care system, and a number of cultural factors such as risk aversion [16][17][18][19]. Against a policy background within which variations in the rates of community use of antibiotics are substantial and remain difficult to explain [28,[30][31][32], evidence is mounting that efforts to educate the public are not producing the desired results [13,33].…”

Pattern and Appropriateness of Antimicrobial Prescriptions for Upper Respiratory Tract and Dental Infections in Male Prisoners in Italy

“…Many investigations have explored the frequency of use of antimicrobials in many settings and for many specific conditions [ 34 , 35 ] but very few could evaluate the appropriateness of individual prescriptions according to indication, and in no cases among detained subjects, and these two peculiarities represent a relevant strength of this investigation. The need to have access to antimicrobial consumption data that are related to clinical information has been recently emphasized in a study investigating the quality of antimicrobial consumption in the community in the European countries, as a relevant requisite to better understand prescribing habits and to identify opportunities for improvement [ 36 ].…”