E-drug: Antibiotic use in 13 European countries
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[Copied from the Scandinavian Journal of Infectious Diseases
(2002;34:366-71) as fair use]
See also News roundup in today's BMJ:
http://bmj.com/cgi/content/full/324/7348/1236/d, copied below. KM
Title: Antibiotic Prescription Rates Vary Markedly Between 13 European
Countries
Authors: Sigvard Molstad; Cecilia Stalsby Lundborg; Anna-Karin Karlsson;
Otto Cars
Abstract: There is a lack of data on antibiotic utilization in most European
countries. In this study, information about the number of antibiotic
prescriptions was obtained for Austria, Belgium, Finland, France, Germany,
Greece, Italy, The Netherlands, Portugal, Spain and the UK from the
Institute for Medical Statistics Health Global Services in the UK. For
Denmark and Sweden the information was obtained from the Danish Medicines
Agency (Laegemiddelstyrelsen) and the National Corporation of Swedish
Pharmacies (Apoteket AB), respectively. Between 1994 and 1997 the number of
prescriptions per 1,000 inhabitants increased in France and Greece whilst
Portugal, Spain and Sweden reported a decrease. In 1997, Greece (1,350),
Spain (1,320) and Belgium (1,070) had the highest numbers of antibiotic
prescriptions per 1,000 inhabitants in the Anatomical Therapeutic Chemical
classification system for drugs group J01 while The Netherlands (390),
Sweden (460) and Austria (480) had the lowest. The most common antibiotic
drug was extended-spectrum penicillin in 6/13 countries, macrolides in
Austria, Finland, Germany and Italy, phenoxymethylpenicillin in Denmark and
Sweden and cephalosporins in Greece. The variation in the number of
antibiotic prescriptions per 1,000 inhabitants between the 13 European
countries was substantial in terms of both total use and use of different
antibiotics.
Staffan Svensson
Dept of Clinical Pharmacology
Sahlgrenska Univ Hospital, Gothenburg, Sweden
staffan.svensson@pharm.gu.se
BMJ 2002;324:1236 ( 25 May )
Greek doctors prescribe the most antibiotics
Roger Dobson Abergavenny
European countries differ substantially in the use of antibiotics, a study
has found.
The variations were in the volume of drugs dispensed and the types of
antibiotics used in the 13 countries surveyed. There were also differences
in prescribing trends.
Greece topped the prescribing list, with 1350 prescriptions per 1000 in the
population, closely followed by Spain, with 1320, and then Belgium, with
1070. The Netherlands, Sweden, and Austria had the lowest, with 390, 460,
and 480.
The report, which points out that studies have shown higher rates of
resistance in southern than in northern Europe in both community acquired
and hospital infections, says that a lack of publicly available, comparable
data on antibiotic use in most European countries has been an obstacle to
investigating links between resistance and use.
The research, reported in the Scandinavian Journal of Infectious Diseases
(2002;34:366-71), looked at prescribing rates in Austria, Belgium, Denmark,
Finland, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain,
Sweden, and the United Kingdom.
"There was a trend towards an increased number of prescriptions per 1000
inhabitants in the countries of Southern Europe," says the report. "When
comparing neighbouring countries, major differences were evident, for
example those between Belgium and The Netherlands."
The most common antibiotic drug in six of the countries was extended
spectrum penicillin. Macrolides were the most common in Austria, Finland,
Germany, and Italy, phenoxymethylpenicillin in Denmark and Sweden, and
cephalosporins in Greece.
The report says: "It seems unlikely that these large differences between
countries reflect differences in the morbidity from bacterial infections and
other explanations must be sought."
It adds, "All countries have an important role to play in ensuring that
validated national and regional data on antibiotic prescribing and sales are
made publicly available. Such data are needed in order to evaluate the
impact of antibiotic prescribing on resistance, morbidity, complications and
mortality."
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