The consumption of quinolones in Portugal, 2005–2014

Abstract

Background Inadequate consumption of antibiotics has social costs as well as serious health consequences including lower response to treatments, prolonged illness, increasing number of hospitalizations and higher risk of complications and mortality. Being aware of the evolution of antibiotic consumption and its pattern of use is essential to develop action plans, which may contribute to their appropriate use. The aim of our study was to assess the evolution of quinolones consumption in Portugal, Health Regions and Districts of Portugal, from 2005 to 2014. Methods Descriptive observational study using as source of information a database of antibiotics prescription in ambulatory provided by Infarmed, National Authority of Medicines and Health Products. Two methods of consumption evaluation were used: DID, expressed in DDD per 1000 inhabitants per day; and PID, expressed in number of packages per 1000 inhabitants per day. Results The quinolone consumption, using the DID method, ranged from 2.42 DID to 2.12 DID, between 2005 and 2014, corresponding to a decrease of 12.35%. At the district level, during the ten years of consumption reporting, it is worth noting the decrease in consumption of quinolones in the vast majority of districts. The district with the greatest consumption reduction was Beja, with a decrease of 28.36% (DID). Regarding the use of the PID method, consumption ranged from 0.315 PID in 2005 to 0.257 PID in 2014, corresponding to a decrease of 18.31%. At district level, all districts decreased consumption in the 10 years under study, with the exception of Portalegre, which had an increase of 5.60%. The district of Beja was the one that showed a greater decrease in the consumption of quinolones (34.44%). In relation to the different generations of quinolones, it was found that the first generation has suffered an important decrease in its consumption (ofloxacin - 73.1%), and the second generation is the most consumed (77%), mainly due to ciprofloxacin and levofloxacin. Ciprofloxacin is the quinolone most consumed, and levofloxacin was the quinolone that presented the greatest increase in consumption. Conclusion This study allowed to verify the differences of results, according to different methods. It was concluded that for a good characterization of consumption differences between health regions and districts, it is necessary to use more than one method of study. Despite the decrease in consumption of quinolones, Portugal continues to have a high consumption when compared to other European countries.