Antibiotic Sales Research Articles

Sale of Antibiotics without Prescriptions in Alexandria, Egypt

Sale of Antibiotics without Prescriptions in Alexandria, Egypt

Threats to global antimicrobial resistance control: Centrally approved and unapproved antibiotic formulations sold in India.

Rising antimicrobial resistance (AMR) is a global health crisis. India has among the highest resistance rates and antibiotic consumption internationally. Extensive use of fixed-dose combination (FDC) antibiotics and of unapproved formulations are claimed contributory factors but there has been no systematic examination of formulations or volumes sold. The aim of the present study was to investigate the regulatory approval status and sales volumes of systemic antibiotics marketed in India. This was an ecological study using regulatory records in India, the UK and the US to determine the approval status in each country of systemic antibiotic FDCs and single-drug formulations (SDFs) sold in India. Pharmatrac® sales data were used to determine the formulations and volumes sold (2007-2012), branded-product numbers and manufacturers. Of 118 systemic antibiotic FDC formulations sold in India, 43 (36%) were approved but 75 (64%) had no record of regulatory approval; four (3%) formulations were approved in the UK and/or US. Almost half of formulations (58/118; 49%) comprised dual antimicrobials, most unapproved in India (43/58; 74%), and many were pharmacologically problematic. In contrast, 80/86 (93%) SDFs were approved in India and over two-thirds in the UK and/or US. Total antibiotic sales increased by 26%, from 2056 million units (2007-08) to 2583 million units (2011-12). FDC sales rose by 38% vs. 20% for SDFs. By 2011-12, FDCs comprised one-third of sales (872 million units). Over one-third of FDCs sold (300.26 million units; 34.5%) were of unapproved formulations. Multinational companies manufactured unapproved formulations and accounted for 19% of all FDC and SDF sales annually. Sales in India of antibiotic FDCs, including unapproved formulations, are rising. In the context of increasing AMR rates nationally and globally, unapproved antibiotic FDCs undermine India's national AMR strategy and should be banned from sale.

India, Pfizer tackling antimicrobial resistance

The Indian Council of Medical Research and the pharmaceutical giant Pfizer are establishing a center in New Delhi to combat the growing threat of antimicrobial resistance. India has among the highest rates of antibiotic consumption and antimicrobial resistance in the world. Reasons for those rates include over-the-counter pharmacy sales and a market flooded with unregulated drugs. One recent study of Indian antibiotic sales data and regulatory records from 2007 to 2012 found that 64% of one class of antibiotic formulations had no record of regulatory approval (Br. J. Clin. Pharmacol. 2018, DOI: 10.1111/bcp.13503). People taking antibiotics for viral infections or antibiotics that don’t work for the microorganism causing the problem “just helps to select out resistant bacteria that then spread around,” says Patricia McGettigan of Queen Mary University of London, the lead author of the study. Pfizer has provided an initial grant of about $1.09 million for the new center,

Treatment practices of households and antibiotic dispensing in medicine outlets in developing countries: The case of Ghana.

Antibiotic resistance, associated with inappropriate drug use, is a global public health threat. The pharmaceutical sectors in developing countries are poorly regulated leading to antibiotic sales and use without a prescription. The study documents the treatment of acute illnesses in households and the antibiotic dispensing practices of medicine sales outlets in Eastern region, Ghana. Twice-weekly illness recall visits were made to 12 households in three rural communities over eight consecutive weeks. Detailed fieldnotes were taken and analysed using a thematic approach. Quantitative counts of health events and treatment were also conducted. Dispensing practices were systematically observed and documented in three rural and three urban medicine outlets for analysis. Fever, abdominal, and respiratory symptoms were the most common causes of ill-health in the 12 households. Most (65%) medicine-use events involved self-treatment with pharmaceuticals; 40% of medicine-use events involved antibiotics, often without a prescription. Although the number of antibiotic transactions without prescription in rural medicine outlets (n = 139, 27.4%) was statistically significantly more than in urban pharmacies (n = 140, 13.5%); z = 6.7, p < .0001), the volume of antibiotics sold in pharmacies was higher. Penicillins were the most commonly dispensed antibiotics constituting 30% of antibiotic sales in urban medicine outlets and 46% in rural ones. The lack of controls in the dispensing of antibiotics, community knowledge and use of antibiotics in ways inconsistent with biomedical recommendations, poverty and perceived barriers to formal healthcare were factors that influenced the inappropriate use of antibiotics. Self-medication, including antibiotic self-prescription, constitutes an integral part of healthcare in the study settings and the qualitative data provides a contextual understanding of over-the-counter antibiotic acquisition and use. Inappropriate antibiotic use is apparent in the study settings. Stricter regulation of the pharmaceutical sector, training of dispensers and evidence-based treatment guidelines, and public education are potential interventions.

Self-medication with antibiotics in Saudi Arabia

IntroductionDespite of the global dilemma of antibiotics resistance, this issue is more worsen in developing countries or places where the antibiotics can be dispensed or purchased without prescription such as in Saudi Arabia. Most health awareness campaigns and published studies regarding the self-medication with antibiotics in Saudi Arabia are conducted within hospitals. The prevalence and reasons of self-medication with antibiotics were not well studied from community perspective in Saudi Arabia. This study was conducted to investigate the prevalence of self-medication with antibiotics in Saudi Arabia. MethodologyA cross-sectional study using online survey and snowball technique was conducted during the period from January 2017 to May 2017 targeting people who are living in Saudi Arabia. ResultsA total of 1264 respondent completed the questionnaire and included in the study. About 34% of respondents have used antibiotic without a prescription, and 81.3% of them knew that it might be harmful to health. The most antibiotic used for self-medication was Amoxicillin/clavulanic acid (45.1%) followed by amoxicillin (39.9%). The most common illness and reasons for seeking antibiotic without prescription were tonsillitis (76.7%) and the previous experience of using a particular antibiotic (52.1%) respectively. The major source of self-medication with antibiotic was previous doctor's prescription (36.6%). ConclusionThe relative high prevalence of self-medication with antibiotics necessitates taking serious steps by health authorities to implement the law of forbidding the sale of antibiotics without prescription.

Tackling antimicrobial resistance in food-producing animals

Tackling antimicrobial resistance in food-producing animals

Molecular epidemiology of the community-associated methicillin-resistant staphylococcus aureus clones: a synthetic review.

The article presents a synthetic molecular characterization of the methicillin-resistant Staphylococcus aureus and describes the most important community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clones that circulate nowadays in the world: the main molecular and epidemiological characteristics, as well as notions related to the clinic of infections produced by these clones and their antibiotic resistance spectrum.The predominant clone of CA-MRSA in North America is USA300 – ST8-IV in North America, in Australia – Queensland (Qld) MRSA (ST93-IV), in Europe – ST80-IV, in Asia there is a high heterogeneity of clones population, in Africa the distribution of CA-MRSA clones is unclear, and in South America – USA 1100 and USA300-Latin American variant are predominant.The molecular diagnosis is performed by highly specialized institutions. The knowledge of clones allows the study of antibiotic resistance spectrum for each one, a fact of great importance for medical practice. Molecular epidemiology of the CA-MRSA shows that lowly restricted sales of antibiotics in shops and pharmacies, as well as medical prescribing practices without a laboratory investigation, especially in Eastern Europe and Asia, contribute to the development of new MRSA clones with increased resistance to antibiotics.

Irrational use and non-prescription sale of antibiotics in Ethiopia: A need for change; a case study conducted at Shambu General Hospital, Shambu, Ethiopia

Irrational use and non-prescription sale of antibiotics in Ethiopia: A need for change; a case study conducted at Shambu General Hospital, Shambu, Ethiopia

Trends and patterns of antibiotic consumption in China's tertiary hospitals: Based on a 5 year surveillance with sales records, 2011-2015.

The consumption of antibiotics is a major driver in the development of antimicrobial resistance. This study aims to identify the trends and patterns of the total antibiotic consumption in China’s tertiary hospitals from 2011 to 2015 by retrospectively analyzing aggregated monthly surveillance data on antibiotic sales made to 468 hospitals from 28 provinces. Antibiotic consumption was expressed in DDD per 1,000 inhabitants per day (DID). We compared population weighted antibiotic consumption patterns in China with European countries using indicators from the European Surveillance of Antimicrobial Consumption (ESAC). Total antibiotic consumption, including all the specific antibiotic class except for aminoglycoside antibacterials, were significantly increased during the study period from an average of 7.97 DID in 2011 to 10.08 DID in 2015. In 2015, the eastern regions of China consumed the most antibiotics using population denominator while the western regions consumed the most using inpatient denominator. Cephalosporins accounted for 28.6% of total DID, followed by beta-lactam-beta-lactamase inhibitor combinations (20.0%), macrolides (17.4%), and fluoroquinolones (10.5%). Antibiotic in parenteral form accounted for nearly half of all antibiotics. Although over the past few years major efforts had been made to reduce the risks of excessive antibiotic use through antibiotic stewardship, total antibiotic consumption showed a significant upward trend during the study period. A consistent preference for cephalosporins, macrolides, beta-lactam-beta-lactamase inhibitor combinations, as well as parenteral preparations was observed.

Doctors Adjacent to Private Pharmacies: The New Ambulatory Care Provider for Mexican Health Care Seekers

BackgroundIn 2010 Mexican health authorities enacted an antibiotic sale, prescription, and dispensation bill that increased the presence of a new kind of ambulatory care provider, the doctors adjacent to private pharmacies (DAPPs). ObjectivesTo analyze how DAPPs’ presence in the Mexican ambulatory care market has modified health care seekers’ behavior following a two-stage health care provider selection decision process. MethodsThe first stage focuses on individuals’ propensity to captivity to the health care system structure before 2010. The second stage analyzes individuals’ medical provider selection in a health system including DAPPs. This two-stage process analysis allowed us not only to show the determinants of each part in the decision process but also to understand the overall picture of DAPPs’ impact in both the Mexican health care system and health care seekers, taking into account conditions such as the origins, evolution, and context of this new provider. We used data from individuals (N = 97,549) participating in the Mexican National Survey of Health and Nutrition in 2012. ResultsWe found that DAPPs have become not only a widely accepted but also a preferred option among the Mexican ambulatory care providers that follow no specific income-level population user group (in spite of its original low-income population target). Our results showed DAPPs as an urban and rapidly expanded phenomenon, presumably keeping the growing pace of new communities and adapting to demographic changes. ConclusionsIndividuals opt for DAPPs when they look for health care: in a nearby provider, for either the most recent or common ailments, and in an urban setting; regardless of most socioeconomic background. The relevance of location and accessibility variables in our study provides evidence of the role taken by this provider in the Mexican health care system.

Comparison of pattern of self-medication among urban and rural population of Telangana state, India

Background: Self-medication is one of the components of self-care, which may treat the disease or result in worsening of the condition due to irrational use of drug.1 In developing countries like India, self-medication is a common practice as it provides a low-cost alternative for people who cannot afford the high cost of clinical service, and is time efficient.Methods: A total of 110 participants completed the study. A printed questionnaire was given to those who were willing to participate in the study and came to buy medicines without consulting a doctor to various pharmacy outlets.Results: Among the group of drugs used antibiotics were the common drugs used in rural area (74%) and cough suppressants (50%) in urban area. Symptoms for opting self-medication were fever and common cold in both the groups. Individuals in both areas took self-medication based on their previous prescriptions (rural 42% vs urban41.6%) and advertisements. Rural individuals preferred self-medication with the opinion of saving time and urban people felt that it was less expensive.Conclusions: There is a difference in the pattern self-medication among rural and urban individuals. It is also to be noted that use of antibiotics may result in problems related to drug resistance. So, it would be advisable to restrict the sale of antibiotics as over the counter drugs.

Decrease in Antibiotic Sales in Brazil After New Control Legislation

Abstract Background Brazil, like many Latin American countries, has struggled with the inappropriate use of antibiotics in the community without a prescription form a physician. Since November 2010, The Brazilian Health Surveillance Agency has established stricter control of antibiotic sales, which requires that a copy of antibiotic prescriptions be retained by the pharmacy for audit. Pharmacists now also have more severe civil and criminal liability if they allow the sale of antibiotics without a prescription. The aim of this study was to analyze the impact of the new legislation preventing the sale of antibiotics in pharmacies without a prescription. Methods The data for antibiotic usage in units was collected from electronic monitoring of pharmacy members of the Brazilian Federation of Pharmacies (FEBRAFAR), which tracked information about the antibiotics sold in approximately 3,000 pharmacies from 1,500 municipalities across Brazil. We compared the sale of antibiotics during two time periods: 12 months prior to the new legislation and 12 months after. Results We observed a reduction in pharmacy sales of each class of antibiotics included in this study following the implementation of the new legislation. Pharmacy sales for 27 (84.4%) of the 32 antibiotics included in the study were reduced in response to the new legislation, whereas sales of five antibiotics were increased. Overall, tetracycline (−57.8%), co-trimoxazole (−28.8%), and amoxicillin (−29.1%) showed the largest reduction of all agents. With month to month analysis, the greatest reduction in units sold/month was observed for the following therapeutic classes: tetracyclines (30.5%), sulfonamides (28.5%), macrolides (25.0%), and penicillins (20.5%). Yearly trend analysis showed a significant reduction in antibiotics during the winter months (average monthly difference: −31.5%, P &amp;lt; 0.05) Conclusion The reduction in the number of antibiotic units sold by pharmacies after the implementation of legislation designed to regulate antibiotic use in Brazil suggests that the policy is successful and will contribute to rational use of antibiotics in Brazil. Disclosures All authors: No reported disclosures.

Assessing the Knowledge, Attitudes, and Practices on Antibiotics Among the General Public Attending the Outpatient Pharmacy Units of Hospitals in Bhutan: A Cross-Sectional Survey.

We assessed the level of knowledge, attitudes, and practices on antibiotics through a questionnaire-based cross-sectional survey among the general public in Bhutan. Of the 692 participants, 52.6% (364) were females with a mean age of 34.2 years. More than half of the respondents showed unsatisfactory knowledge varying significantly from 23.1% to 69.6%. Cotrimoxazole (septran) was the least known while amoxicillin was the most known antibiotics assessed. Two-thirds of the responsents (267) knew that inappropriate use of antibiotics could lead to antimicrobial resistance and 89% (319) were aware of the need to complete the antibiotic courses. In bivariate analysis, satisfactory knowledge was associated with the education level of graduate and higher as compared with no education. This study revealed unsatisfactory knowledge and attitude but satisfactory practices on antibiotics use among participants. Efforts are needed to improve public awareness on antibiotics. Enforcement of regulations on sale of antibiotics over the counter needs a revamp.

Brazil's resolutions to regulate the sale of antibiotics: Impact on consumption and Escherichia coli resistance rates.

The aim of this study was to determine the impact of two resolutions to restrict antibiotic use (RDCs no. 44/2010 and 20/2011) in the Campinas metropolitan area (Sao Paulo, Brazil) on antibiotic consumption, resistance rates, and trends in Escherichia coli-causing community-acquired urinary tract infection (UTI). The annual retail sale information of antibiotics from drugstores in the Campinas metropolitan area between 2008 and 2012 were obtained through the Intercontinental Medical Statistics Health of Brazil. The daily-defined dose (DDD)/1000 inhabitants/day was calculated from these data to measure consumption. To examine resistance rates, we performed an observational retrospective study in a Campinas teaching hospital, where urinary cultures from outpatients with a clinical suspicion of UTI between October 2009 and September 2015 were analyzed. We observed an increase in rates of antibiotic sales from 2008 to 2011 (cephalosporin: 216.8%, quinolones: 170.9%, aminopenicillins: 140.9%), followed by a decrease in sales in 2012 (cephalosporin: 19.4%, quinolones: 12.7%, aminopenicillins: 11.1%). Sale of nitrofurans, however, did not significantly change during this period. In the retrospective analysis, we observed a significant increasing trend of E. coli resistance for all antibiotic classes, except nitrofurans and folate pathway inhibitors. We found changes in antibiotic consumption, with an initial increase, followed by a decrease in sales after implementation of the resolutions. However, bacterial resistance does not appear to be affected by the RDCs.

Massive misuse of antibiotics by university students in all regions of China: implications for national policy

Antimicrobial resistance (AMR) is one of the greatest threats to global health this century. The primary cause of AMR is antibiotic misuse, especially routine use of antibiotics for self-limiting illnesses. This study aimed to explore behaviours related to antibiotic use in university students across China. An electronic questionnaire was distributed at a major university in each of the six regions. A cluster random sampling method was adopted. The χ2 test and logistic regression were used to assess the relationship between knowledge and behaviour. A total of 11,192 students completed the questionnaire. In the past month, 3337 students (29.8%) reported a self-limiting illness, of whom 913 (27.3%) saw a doctor, 600 (65.7%) of whom were prescribed antibiotics [190 (31.7%) by infusion]; 136 students (22.7%) asked for and received antibiotics. Of the 1711 students (51.3%) who treated themselves, 507 (29.6%) self-medicated with antibiotics. In the past year, 23.0% of students had used antibiotics as prophylaxis, 63.1% kept a personal stock of antibiotics and 56.0% had bought antibiotics at a drugstore (two-thirds without a prescription). Students with lower knowledge scores about antibiotics were significantly more likely to see a doctor, be prescribed with antibiotics, self-medicate with antibiotics, and use antibiotics prophylactically. This massive misuse of antibiotics for self-limiting illnesses by well-educated young adults is a serious concern. A national campaign is urgently required to address rational prescribing of antibiotics by doctors, enforce existing restrictions on over-the-counter sale of antibiotics, and educate the general public about antibiotics and the management of self-limiting illnesses.

Self-Medication Practices With Antibiotics in Students of Medicine and Dentistry in Greece

Self-medication with antibiotics is a major reason for the spread of antibiotics resistance. The aim of the present study was to assess practice and perception of self medication among students. A questionnaire-based, cross-sectional survey, concerning economic conditions and health practices of antibiotic self administration in students, for the previous 6-months time period during the last year of their studies, was conducted in the Faculties of Medicine and Dentistry from January to April 2016. A total of 500 copies of questionnaires were distributed. A total of 384 forms were completed (220 students from Faculty of Medicine and 164 from Faculty of Dentistry) and returned (response rate 76.8%). According to the results, 258 (67.2%) students had a monthly income of less than 300 Euro, while 77 (20%) students did not have any health insurance. Out of 384 students that responded, 86 (22,4%) were self-medicated with antibiotics the last 6 months. The principal symptoms for seeking self medication with antibiotics were pain, cough and fever as reported by 67 (78%) students. Out of 86 self medicated students 68 (79%) were medical students. Moreover, only 51 (59%) of self medicated students were completed the full course of antibiotic regimen while 41 of them (47.7%) were taking wrong dosages during the treatment period and 28 (32.5%) reported adverse events related to antibiotics. The main reason reported for not visiting a medical doctor (75.6%), was the prior use of the same antibiotic in the past. Male gender and studies in school of medicine were identified as independent risk factors of self medication with antibiotics. Self administration with antibiotics is common between students in health sciences and can lead to wrong dosages or adverse events. Strict regulations on antibiotic sales and education reinforced by further health care reform are recommended.

English

Chad is a country where self-medication and use of antibiotic without medical prescriptions are still observed. These practices lead to the apparent emergence of resistance to antibiotics for bacteria. The aim of this study was to assess the abusive and inappropriate use of antibiotics among the communities. The surveys were conducted in N&#39;Djamena and Moundou, two major cities of Chad. All the respondents were aged more than 14. They had different social status and some were married. All were interviewed through questionnaire sheets. The collected data were cleaned and validated using the Statistical Software Package for the Social analysis. Data analysis was performed using the Pearson chi-square test. Of the 500, 472 returned sheets contained complete information. Therefore, the response rate was 94.4%. 296 (62.7%) were male and 176 (37.3%) women. The majority of the participants were between 25-34 years (36.9%). Their levels of training vary: primary (40.8%), secondary (33.1%) and higher (26.1). Their professional and marital status also varied. The marital status revealed 37.7% single and 46.8% married. The rate of antibiotic use was significant among the young people, from 25 to 34 years old (61.49%; p = 0.002). As far as the antibiotics acquisition is concerned, 33.2% of the people interviewed affirmed that they had received probabilistic medical prescription of drugs of which 2.5% is on customers&rsquo; demand. It was also established that 6.8% of medicines were purchased without medical prescriptions and 4.2%, on the advice of unqualified street vendors. With regards to the sources of drugs, 20.6% of the antibiotics were purchased from pharmacies and 11.0% from street vendors. Bad practices in the use of antibiotics could be related to knowledge gaps on the subject. Young people, in particular, those with low incomes and lower level of education were the most concerned. Educational, informational, communicative initiatives and application of regulations on sales of antibiotics are needed to control the misuse of antibiotic in Chad. Key words: Antibiotic resistance, socio-demographic characteristics, bacteries, virus, education, Chad.

Self-medication with antibiotics in Serbian households: a case for action?

Background Irregular antibiotic use, including self-medication contributes to the development of antibiotic resistance. One method of accessing antibiotic use in the community is through obtaining an in house inventory of drugs. Objective The aim of this study was to investigate the extent of storage and self-medication with antibiotics agents in households in Novi Sad, Serbia. Setting Households in Novi Sad. Method The study was performed during a 4-month period (October 2015-January 2016) using a sample of 112 households in Novi Sad, Serbia. Two trained interviewers performed the survey by visiting each household. The study consisted of making an inventory of all drugs in household and a semi-structured interview about drug use practices and perceptions. Main outcome measure Number of antibiotics obtained without prescription. Results Out of 112 surveyed households, antibiotics were encountered in 55 (49.1%). Antibiotics constituted 11.98% (92/768) of total number of drug items in households. Out of all antibiotics in households, 41 (44.57%) were not in current use, and presented left-overs from previous treatment. Antibiotics were usually acquired with prescription (67, 67.7%), while about a quarter of packages were used for self-medication-purchased at pharmacy without prescription (19, 20.65%) or obtained through friends or family member (6, 6.52%).The most commonly used antibiotics for self-medication was amoxicillin (reported indications included common cold, cough, pharyngitis and tooth-ache). Conclusion Antibiotics were present in large share of households in Novi Sad. Self-medication with antibiotics and sale of antibiotics without prescription represent an important problemin Serbia.

Sale of antibiotics without a prescription at community pharmacies in urban China: a multicentre cross-sectional survey.

To quantify sales of antibiotics without a medical prescription and to assess the quality of pharmacy services in relation to the antibiotics sold in community pharmacies in urban China. A multicentre cross-sectional survey of community pharmacies was undertaken in 2015 using the simulated client method. Two clinical case scenarios (paediatric diarrhoea and adult acute upper respiratory infection) were presented at systematically sampled community pharmacies in Eastern (Nanjing), Central (Changsha) and Western China (Xi'an). Of 256 pharmacies, antibiotics were obtained without a prescription from 55.9% (95% CI: 49.5%-62.0%) when paediatric diarrhoea was simulated and from 77.7% (95% CI: 72.1%-82.7%) when adult respiratory infection was simulated. Of the pharmacies where antibiotics were dispensed, 83.9% and 66.3% dispensed after the simulated clients requested or insisted in the case of paediatric diarrhoea and adult respiratory infection, respectively. Significant differences ( P < 0.001, χ 2 test) in inappropriate antibiotic dispensing were found among cities, with 57.7%, 37.3% and 73.7% in the case of paediatric diarrhoea and 60.8%, 80.7% and 96.1% in adult respiratory infection in Nanjing, Changsha and Xi'an, respectively. Pharmacists were available in only 14.8% (95% CI: 10.7%-19.8%) of the pharmacies. The performance of pharmacy staff regarding the provision of information and advice was unsatisfactory. Antibiotics were easily obtained without a prescription in community pharmacies in urban China. Measures to enhance the enforcement of prescription-only regulations and training programmes for pharmacy staff to promote the appropriate use of antibiotics are warranted.

Policy implementation for methicillin-resistant Staphylococcus aureus in seven European countries: a comparative analysis from 1999 to 2015

ABSTRACTBackground: Policies to reduce methicillin-resistant Staphylococcus aureus (MRSA) infections, both healthcare-acquired (HA-MRSA) and livestock-associated (LA-MRSA) are implemented Europe-wide, but evaluations are difficult for countries yet to implement such policies. A descriptive study was conducted, describing multinational MRSA rates and policy implementation, focusing on MRSA mandatory surveillance. We also investigated antibiotic use and MRSA rates and the use of veterinary antibiotics.Methods: This study used Europe-wide surveillance data on infectious diseases (EARS-Net), antibiotic consumption (ESAC-Net), and veterinary medicine (ESVAC). We visualized LA- and HA-MRSA related policies and MRSA rates from 1999 to 2015 in seven European countries. Changes in MRSA rates after implementation of an MRSA mandatory surveillance policy were investigated by setting each country as rate of 1.0 and compared countries with and without such policy. Correlations between antibiotic use and MRSA rates from 1999 to 2012 were investigated using defined daily dose. Sales data were used to investigate veterinary antibiotic use.Results: MRSA rates were 1–45.4% across the seven countries between 1999 and 2015. MRSA rates changed between 0.61 and 0.24 after the implementation of mandatory surveillance policies within a 6–12 year span. The rate of decrease rate in implemented and non-implemented countries ranged from 10% in Spain to 76% in the UK. The correlation between MRSA rate and cephalosporin consumption was r = 0.419, and for fluoroquinolones r = 0.305. Mean annual sales of veterinary cephalosporin and quinolone antibiotics were lowest in the UK (0.8 mg/PCU) and highest in Spain (9.7 mg/PCU) between 2009 and 2014.Conclusions: There were similar but different health policy implications in the seven countries regarding LA- and HA-MRSA. Although causation could not be defined, some policies such as mandatory surveillance may be helpful for countries that have yet to implement an MRSA policy. Further investigations are needed to evaluate each policies.