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Lancet Infect Dis. 2014 May;14(5):381-7. doi: 10.1016/S1473-3099(14)70071-4. Epub 2014 Mar 20.

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

Author information

1
Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
2
Health Technologies and Pharmaceuticals, Division of Health Systems and Public Health, WHO Regional Office for Europe, Copenhagen, Denmark.
3
Scientific Centre of Drug and Medical Technology Expertise of the Ministry of Health, Yerevan, Armenia.
4
Ministry of Health of Azerbaijan Republic, Analytical Expertise Centre for Medicines, Baku, Azerbaijan.
5
Department on Organisation of Medicines Provision, Ministry of Health, Minsk, Belarus.
6
Agency for Medicines and Medical Devices of Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina.
7
JSC "My family Clinic", Tbilisi, Georgia.
8
National Institute of Public Health of Kosovo and Faculty of Medicine, University of Pristina, Pristina, Kosovo.
9
CitiHope International, Bishkek, Kyrgyzstan.
10
Agency for Medicines and Medical Devices of Montenegro, Podgorica, Montenegro.
11
Agency of Medicines, Chisinau, Moldova.
12
Medicines and Medical Devices Agency of Serbia, Belgrade, Serbia.
13
Avicenna Tajik State Medical University, Dushanbe, Tajikistan.
14
Ministry of Health of Turkey, Turkish Medicines and Medical Devices Agency, Ankara, Turkey.
15
Croatian Committee for Antibiotic Resistance Surveillance, Croatian Academy for Medical Sciences, Zagreb, Croatia.
16
Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium. Electronic address: herman.goossens@uza.be.

Abstract

BACKGROUND:

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.

Comment in

PMID:
24657114
DOI:
10.1016/S1473-3099(14)70071-4
[Indexed for MEDLINE]

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