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JAC Advance Access published online on May 30, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl188
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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 August 23, 2005
Revised April 12, 2006
Accepted April 16, 2006

Original article

European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe

Matus Ferech 1 * {dagger}, Samuel Coenen 2 {dagger}, Surbhi Malhotra-Kumar 1, Katerina Dvorakova 1, Erik Hendrickx 3, Carl Suetens 3, Herman Goossens 4, and on behalf of the ESAC Project Group {ddagger}

1 Laboratory of Microbiology, University of Antwerp, Antwerp, Belgium
2 Department of General Practice, University of Antwerp, Antwerp, Belgium; Fund for Scientific Research--Flanders, Brussels, Belgium
3 Unit of Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
4 Laboratory of Microbiology, University of Antwerp, Antwerp, Belgium; Laboratory of Microbiology, Leiden University Medical Center, Leiden, The Netherlands

* To whom correspondence should be addressed.
Matus Ferech, E-mail: matus.ferech{at}ua.ac.be


  Abstract

Background: The ESAC project, granted by DG SANCO of the European Commission, is an international network of surveillance systems, aiming to collect comparable and reliable data on antibiotic use in Europe. Data on outpatient antibiotic use were collected from 34 countries using the ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic antibiotics aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID). Outpatient antibiotic (ATC J01) use in 25 European countries, able to deliver valid data, was analysed.

Results: Total outpatient antibiotic use in 2003 varied by a factor of 3 between the country with the highest (31.4 DID in Greece) and the country with the lowest (9.8 DID in the Netherlands) use. General use patterns in individual countries as well as trends during the period 1997-2003 are described in this paper, while major antibiotic classes (penicillins, cephalosporins, macrolides/lincosamides/streptogramins and quinolones) will be analysed in detail in separate papers.

Conclusion: The ESAC project established for the first time a credible alternative to industry sources for the collection of internationally comparable data on antibiotic use in Europe, based on cooperation between regulatory authorities, scientific societies, health insurers and professional organizations. These data provide a tool for assessing public health strategies aiming to optimize antibiotic prescribing.

Keywords: antibiotic use; drug consumption; pharmacoepidemiology; ambulatory care; Europe.

{dagger}These authors contributed equally to this work.

{ddagger}Members are listed in the Acknowledgements section.


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