Abstract
ObjectivesData on consumption of penicillins in the community were collected from 30 EU/European Economic Area (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 penicillins.MethodsFor the period 1997–2017, data on consumption of penicillins, i.e. β-lactam antibacterials, penicillins (ATC group J01C), 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. Consumption of penicillins was analysed based on ATC-4 subgroups, and presented as trends, seasonal variation, presence of change-points and compositional changes.ResultsIn 2017, consumption of penicillins in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 4.9 between countries with the highest (Spain) and the lowest (the Netherlands) consumption. An increase in consumption of penicillins, which was not statistically significant, was observed between 1997 and 2003 and up to 2010. A decrease, which was not statistically significant, was observed from 2010 onwards. Proportional consumption of combinations of penicillins, including β-lactamase inhibitors (J01CR) increased during 1997–2017, which coincided with a decrease in the proportional consumption of extended-spectrum penicillins (J01CA) and narrow-spectrum penicillins (J01CE).ConclusionsConsiderable variation in the patterns of consumption of penicillins was observed between EU/EEA countries. The consumption of penicillins in the EU/EEA community did not change significantly over time, while the proportional consumption of combinations of penicillins increased.
Highlights
This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of penicillins for 30 EU/European Economic Area (EEA) countries in 2017 (Table 1)
Because b-lactamase inhibitors (J01CG) are given in conjunction with extended-spectrum penicillins (J01CA), we focused on only the four main subgroups: penicillins with extended-spectrum [J01CA; extended-spectrum penicillins (ESP)], b-lactamase-sensitive penicillins [J01CE; narrow-spectrum penicillins (NSP)]; b-lactamase-resistant penicillins [J01CF; penicillinase-resistant penicillins (PRP)], and combinations of penicillins including b-lactamase inhibitors [J01CR; combinations of penicillins (COP)]
In 2017, four substances accounted for 90% of the consumption of penicillins in the community expressed in DDD per 1000 inhabitants per day: amoxicillin/clavulanic acid (45.9% in 2017 compared with 42.4% in 2009), amoxicillin
Summary
This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of penicillins for 30 EU/European Economic Area (EEA) countries in 2017 (Table 1). It 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.[2,3] In 2017, penicillins represented 42.3% of antibiotic consumption in the community.[4] The objective of this study was to analyse temporal trends, seasonal variation and the presence of change-points in consumption of penicillins in the community (i.e. primary care sector) for the period 1997–2017, as well as to analyse the composition of consumption of penicillins over time.
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