Abstract
The aim of this study was to determine and describe trends in antibiotics utilization in Serbia over a ten-year period. Data were retrieved from publicly available annual reports (2010–2019). The results were expressed as Defined Daily Dose (DDD) per 1000 inhabitants per day (DID). All calculations were performed using the DDD values for the 2020 Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) version for each year of the study, to account for the DDD changes during the study period. Antibiotics were classified using the WHO Access, Watch, Reserve (AWaRe) classification. Total utilization of antibacterials for systemic use increased from 17.25 DID in 2010 to 28.65 DID in 2019. A statistically significant increasing trend in the use of the Watch category antibiotics was observed. A tendency towards use of broad-spectrum antibiotics, apparent by a statistically significant increase in the rate of utilization of broad-spectrum macrolides, quinolones and third-generation cephalosporins vs. narrow-spectrum ones, as well as a significant increasing trend in the use of quinolones was identified. Total antibiotic utilization was found to be well above the European average. Several specific problem areas were identified, which requires further efforts to improve antibiotic prescribing. The present study provides the information needed to facilitate antibiotic stewardship in Serbia further and proposes specific interventions to optimize antibiotic use in Serbia.
Highlights
Antimicrobial resistance (AMR) is one of the biggest challenges of the 21st century, identified by the World Health Organization (WHO) as one of the top 10 global public health threats humanity is facing [1]
A global action plan (GAP) on antimicrobial resistance was endorsed at the World Health Assembly in May 2015 with a number of strategic objectives [2]
17.25 Dose/1000 inhabitants/day (DID) in 2010 to 29.66 DID in 2015, which was followed by a decrease in utilization to 21.60 in 2017 and an increase to 28.65 DID in 2019
Summary
Antimicrobial resistance (AMR) is one of the biggest challenges of the 21st century, identified by the World Health Organization (WHO) as one of the top 10 global public health threats humanity is facing [1]. A global action plan (GAP) on antimicrobial resistance was endorsed at the World Health Assembly in May 2015 with a number of strategic objectives [2]. These include improved awareness and understanding of antimicrobial resistance, strengthening surveillance and research, reducing the incidence of infections, optimizing the use of antimicrobials and ensuring sustainable investment in countering. This is achieved through controlling infection and optimizing drug use. These activities include providing adequate water supply, sanitation and hygiene, infection prevention and control, immunization, laboratory services, workforce education and antibiotic supply chain management [3].
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