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JAC Advance Access first published online on May 12, 2006
This version published online on May 22, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl147
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received December 22, 2005
Revised March 19, 2006
Accepted March 23, 2006

Original article

Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997-2002)

R. H. Vander Stichele 1, M. M. Elseviers 2, M. Ferech 3, S. Blot 4, H. Goossens 5 *, and on behalf of the European Surveillance of Antibiotic Consumption (ESAC) Project Group {dagger}

1 ESAC Management Team, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium; Heymans Institute of Pharmacology, Ghent University, De Pintelaan, 185, B-9000 Gent, Belgium
2 ESAC Management Team, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium; Department of Nursing Research, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
3 ESAC Management Team, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
4 ESAC Management Team, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium; Department of Intensive Care, Ghent University Hospital, De Pintelaan, 185, B-9000 Gent, Belgium
5 ESAC Management Team, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium; Leiden University Medical Center, Postbus 9600, 2333 RC Leiden, The Netherlands

* To whom correspondence should be addressed.
H. Goossens, E-mail: Herman.Goossens{at}uza.be


  Abstract

Objectives: To collect reliable, comparable and publicly available data on hospital use of antibiotics in Europe aggregated at the national level (1997-2002).

Methods: Consumption data of systemic antibiotics in Anatomical Therapeutic Chemical (ATC) class J01 were collected and expressed in defined daily doses (DDD) per 1000 inhabitants per day. Valid data for 2002 were available for 15 countries, and 6 year trends for 10 countries. Comparison with ambulatory care (AC) consumption data was possible in 14 countries.

Results: In 2002, median national hospital antibiotic consumption in Europe was 2.1 DDD/1000 inhabitants/day in Europe, ranging from 3.9 in Finland and France to 1.3 in Norway and Sweden. Hospital care (HC) consumption as a proportion of total antibiotic consumption ranged from 17.8% to 6.4%. The consumption of hospital-specific antibiotics ranged from 0.43 DDD/1000 inhabitants/day in Greece and 0.08 in Sweden. Six-year trends in consumption were stable, except for rising co-amoxiclav exposure and more rapid market penetration of new antibiotics (e.g. levofloxacin) in some countries. There was a strong, positive correlation between the extent of antibiotic use in AC and in HC (Spearman coefficient 0.745; P = 0.002), both for overall use and for use of five main classes (not macrolides and ‘others’). In contrast to AC consumption no substantial seasonal variation in consumption was observed.

Conclusions: It was cumbersome but feasible to collect ecological data on hospital antibiotic consumption in a set of 15 European countries on a retrospective basis, illustrating substantial cross-national variations in the extent and distribution of exposure to antibiotics in hospital care.

Keywords: antibacterial agents; data collection; hospitals; drug utilization; Europe; factual databases; microbial drug resistance.
{dagger} See the Acknowledgements section for a list of national representatives. The original published version of this paper did not contain a dateline. This version now contains the correct dateline.
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