Abstract

ObjectivesData on cephalosporin 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 subgroups of cephalosporins.MethodsFor the period 1997–2017, data on consumption of cephalosporins (i.e. first-, second-, third- and fourth-generation cephalosporins; ATC subgroups J01DB, J01DC, J01DD and J01DE, respectively) in the community and 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. Cephalosporin consumption was analysed based on ATC-4 subgroup, and presented as trends, seasonal variation, presence of change-points and compositional changes.ResultsIn 2017, cephalosporin consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 285 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Cephalosporin consumption did not change significantly between the first quarter of 1997 and the last quarter of 2017. Seasonal variation decreased significantly over time. Proportional consumption of second- and third-generation cephalosporins significantly increased over time compared with that of first-generation cephalosporins, and proportional consumption of fourth-generation cephalosporins significantly decreased compared with that of second- and third-generation cephalosporins.ConclusionsDespite considerable variation between countries in the composition of cephalosporin consumption and trends over time, a significant shift towards consumption of more broad-spectrum cephalosporins in the community was observed across the EU/EEA during 1997–2017.

Highlights

  • This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of cephalosporins in the community for 30 EU/EEA countries in 2017

  • Carbapenems and other cephalosporins and penems is very small in the community in EU/EEA countries, this article focusses on consumption of first, second, third- and fourth-generation cephalosporins (Table 1).[2]

  • The present study updates previous ESAC studies published in 2006 and 2011, and in doing so it provides updated comparable and reliable information on antibiotic consumption that can aid in fighting the global problem of antimicrobial resistance.[3,4]

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Summary

Introduction

This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of cephalosporins in the community (i.e. primary care sector) for 30 EU/EEA countries in 2017. Carbapenems and other cephalosporins and penems is very small in the community in EU/EEA countries, this article focusses on consumption of first-, second-, third- and fourth-generation cephalosporins (Table 1).[2] The present study updates previous ESAC studies published in 2006 and 2011, and in doing so it provides updated comparable and reliable information on antibiotic consumption that can aid in fighting the global problem of antimicrobial resistance.[3,4] In 2017, cephalosporins represented 11.6% of antibiotic consumption in the community.[5] The objective of this study was to analyse temporal trends, seasonal variation and the presence of change-points in cephalosporin.

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