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JAC Advance Access published online on July 6, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkm248
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© The Author 2007. 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

Surveillance of outpatient antibiotic consumption in Spain according to sales data and reimbursement data

José Campos1,2,*, Matus Ferech3, Edurne Lázaro4, Francisco de Abajo4, Jesús Oteo1, Peter Stephens5 and Herman Goossens3,6

1 Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain 2 Consejo Superior de Investigaciones Científicas, Madrid, Spain 3 Laboratory of Microbiology, University of Antwerp, Antwerp, Belgium 4 División de Farmacoepidemiología y Farmacovigilancia, Agencia Española de Medicamentos y Productos Sanitarios, Madrid, Spain 5 IMS Health, London NW1 6JB, UK 6 Laboratory of Microbiology, Leiden University Medical Center, Leiden, The Netherlands

Received 23 March 2007; returned 3 May 2007; revised 29 May 2007; accepted 12 June 2007

* Corresponding author. Tel: +34-918-22-3650; E-mail: jcampos{at}isciii.es

Objectives: National data on antibiotic consumption are needed in order to interpret trends in antibiotic resistance. We compared antibiotic prescription reimbursement data and sales data in Spain.

Methods: Data covering the years 2002, 2004 and 2005 were examined. Reimbursement data for ambulatory care were provided by the Spanish Agency for Medicines and Healthcare Products and sales data by International Medical Statistics Health. Quantities were standardized using the defined daily dose per 1000 inhabitants per day (DID) in accordance with the anatomical therapeutic classification.

Results: Sales data increased from 26.33 DID in 2002 to 28.12 DID in 2004 and 28.93 DID in 2005. Estimates based on equivalent reimbursement data were ~30% lower and increased from 18.01 DID in 2002 to 18.48 DID in 2004 and 19.29 DID in 2005. The differences were greatest for amoxicillin, amoxicillin/clavulanic acid, clarithromycin and cefuroxime.

Conclusions: Antibiotic consumption as estimated from reimbursement data is substantially less than that from sales data. This finding has major implications for national surveillance of antibiotic consumption.

Key Words: antibiotic resistance , self-antibiotic medication , ESAC , European Surveillance of Antimicrobial Consumption


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