Consumption of antibiotics in the community, European Union/European Economic Area, 1997–2017
Robin Bruyndonckx, Niels Adriaenssens, Ann Versporten, Niel Hens, Dominique L. Monnet, Geert Molenberghs, Herman Goossens, Klaus Weist, Samuel Coenen, the ESAC-Net study group, Reinhild Strauß, Eline Vandael, Stefana Sabtcheva, Arjana Tambić Andrašević, Isavella Kyriakidou, Jiřı́ Vlček, Ute Wolff Sönksen, Elviira Linask, Emmi Sarvikivi, Karima Hider‐Mlynarz, Doreen Richter, Flora Kontopidou, Mária Matúz, Gudrun Aspelund, Karen Burns, Filomena Fortinguerra, Elīna Dimiņa, Jolanta Kuklytė, Marcel Bruch, Peter Zarb, Stephanie Natsch, Hege Salvesen Blix, Anna Olczak-Pieńkowska, Ana Silva, Gabriel Adrian Popescu, Tomáš Tesař, Milan Čižman, Antonio López Navas, Vendela Bergfeldt, Susan Hopkins
Abstract
OBJECTIVES: Data on antibiotic consumption in the community were collected from 30 EU/EEA countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main antibiotic groups. METHODS: For the period 1997-2017, data on consumption of antibiotics, i.e. antibacterials for systemic use (ATC group J01), in the community, aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Antibiotic consumption was analysed based on ATC-3 groups, and presented as trends, seasonal variation, presence of change-points and compositional changes. RESULTS: In 2017, antibiotic consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor 3.6 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Antibiotic consumption in the EU/EEA did not change significantly over time. Antibiotic consumption showed a significant seasonal variation, which decreased over time. The number of DDD per package significantly increased over time. The proportional consumption of sulphonamides and trimethoprim (J01E) relative to other groups significantly decreased over time, while the proportional consumption of other antibacterials (J01X) relative to other groups significantly increased over time. CONCLUSIONS: Overall, antibiotic consumption in the community in the EU/EEA did not change during 1997-2017, while seasonal variation consistently decreased over time. The number of DDD per package increased during 1997-2017.