Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe

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• 作者：Ann Versporten ; MPH^a ; Ganna Bolokhovets ; PhD^b ; Lilit Ghazaryan ; MPharm^c ; Vafa Abilova ; MPharm^d ; Galina Pyshnik^e ; Tijana Spasojevic ; MPharm^f ; Irma Korinteli ; MD^g ; Lul Raka ; PhD^h ; Baktygul Kambaralieva ; MScⁱ ; Lidija Cizmovic ; MPharm^j ; Angela Carp ; MPharm^k ; Vesela Radonjic ; PhD^l ; Nargis Maqsudova ; MPharm^m ; Hatice Demet Celik ; MScPharmⁿ ; Marina Payerl-Pal ; MD^o ; Hanne Bak Pedersen ; MSc^b ; Nina Sautenkova ; MPharm^b ; Prof Herman Goossens ; PhD^a ; ^{herman.goossens@uza.be" class="auth_mail} ; on behalf of the WHO/Europe-ESAC Project Group
• 刊名：The Lancet Infectious Diseases
• 出版年：May 2014
• 年：2014
• 卷：14
• 期：5
• 页码：381-387
• 全文大小：483 K

文摘

There are no reliable data on antibiotic use in non-European Union (EU) southern and eastern European countries and newly independent states. We aimed to collect valid, representative, comparable data on systemic antimicrobial use in these non-EU countries of the WHO European region.

Methods

Validated 2011 total national wholesale antibiotic-use data of six southern and eastern European countries and regions and seven newly independent states were analysed in accordance with the WHO anatomical therapeutic chemical (ATC)/defined daily doses (DDD) method and expressed in DDD/1000 inhabitants per day (DID).

Findings

Total (outpatients and hospital care) antibiotic use ranged from 15·3 DID for Armenia to 42·3 DID for Turkey. Co-amoxiclav was mainly used in Georgia (42·9% of total antibiotic use) and Turkey (30·7%). Newly independent states used substantial quantities of ampicillin and amoxicillin (up to 55·9% of total antibiotic use in Azerbaijan). Montenegro and Serbia were the highest consumers of macrolides (15·8% and 19·5% of total antibiotic use, respectively), mainly azithromycin. Parenteral antibiotic treatment is common practice: 46·4% of total antibiotic use in Azerbaijan (mainly ampicillin; 5·3 DID) and 31·1% of total antibiotic use in Tajikistan (mainly ceftriaxone; 4·7 DID).

Interpretation

This study provides publicly available total antibiotic-use data for 13 non-EU countries and areas of the WHO European region. These data will raise awareness of inappropriate antibiotic use and stimulate policy makers to develop action plans. The established surveillance system provides a method to develop quality indicators of antibiotic use and to assess the effect of policy and regulatory actions.

Funding

Netherlands Ministry of Health, Welfare, and Sport, and EU.