Abstract
ObjectivesData on quinolone consumption 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 main subgroups of quinolones.MethodsFor the period 1997–2017, data on consumption of quinolones, i.e. ATC group J01M, 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. Quinolone consumption was analysed by subgroups based on pharmacokinetic profile, and presented as trends, seasonal variation, presence of change-points and compositional changes.ResultsIn 2017, quinolone consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 8.2 between countries with the highest (Bulgaria) and the lowest (Norway) consumption. The second-generation quinolones accounted for >50% of quinolone consumption in most countries. Quinolone consumption significantly increased up to 2001, and did not change significantly afterwards. Seasonal variation increased significantly over time. Proportional consumption of third-generation quinolones significantly increased over time relative to that of second-generation quinolones, while proportional consumption of both third- and second-generation quinolones significantly increased relative to that of first-generation quinolones. Levofloxacin and moxifloxacin represented >40% of quinolone consumption in the community in southern EU/EEA countries.ConclusionsQuinolone consumption in the community is no longer increasing in the EU/EEA, but its seasonal variation continues to increase significantly as is the proportion of quinolones to treat respiratory infections.
Highlights
This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of quinolones in the community for 30 EU/European Economic Area (EEA) countries in 2017. 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]
Where data were available, quinolone consumption was expressed in packages per 1000 inhabitants per day
In 2017, four substances accounted for 90% of quinolone consumption in the community expressed in DDD per 1000 inhabitants per day: ciprofloxacin (48.6% in 2017 compared with 50.8% in 2009), levofloxacin (28.8% in 2017 compared with 11.8% in 2009), norfloxacin (10.4% in 2017 compared with 18.2% in 2009) and moxifloxacin (7.2% in 2017 compared with 7.4% in 2009) (Table 1)
Summary
This article presents data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net,[1] formerly ESAC) on consumption of quinolones in the community (i.e. primary care sector) for 30 EU/European Economic Area (EEA) countries in 2017. 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, quinolones represented 9.5% of antibiotic consumption in the community.[4] As in the previous series, quinolones were classified in three generations as introduced by Ball,[5] based on their chemical structure and antimicrobial activity.[2,3] The objective of this study was to analyse temporal trends, seasonal variation and the presence of change-points in quinolone consumption in the community for the period.
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