title: Surveillance of outpatient antibiotic consumption in Spain according to sales data and reimbursement data.
abstract: OBJECTIVE
  National data on antibiotic consumption are needed in order to interpret trends in antibiotic resistance. We compared antibiotic prescription reimbursement data and sales data in Spain.
  
  
  METHODS
  Data covering the years 2002, 2004 and 2005 were examined. Reimbursement data for ambulatory care were provided by the Spanish Agency for Medicines and Healthcare Products and sales data by International Medical Statistics Health. Quantities were standardized using the defined daily dose per 1000 inhabitants per day (DID) in accordance with the anatomical therapeutic classification.
  
  
  RESULTS
  Sales data increased from 26.33 DID in 2002 to 28.12 DID in 2004 and 28.93 DID in 2005. Estimates based on equivalent reimbursement data were ~30% lower and increased from 18.01 DID in 2002 to 18.48 DID in 2004 and 19.29 DID in 2005. The differences were greatest for amoxicillin, amoxicillin/clavulanic acid, clarithromycin and cefuroxime.
  
  
  CONCLUSIONS
  Antibiotic consumption as estimated from reimbursement data is substantially less than that from sales data. This finding has major implications for national surveillance of antibiotic consumption.
authors.affiliation: Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain. jcampos@isciii.es
authors.forename: José
authors.initials: J
authors.lastname: Campos
authors.forename: Matus
authors.initials: M
authors.lastname: Ferech
authors.forename: Edurne
authors.initials: E
authors.lastname: Lázaro
authors.forename: Francisco
authors.initials: F
authors.lastname: de Abajo
authors.forename: Jesús
authors.initials: J
authors.lastname: Oteo
authors.forename: Peter
authors.initials: P
authors.lastname: Stephens
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data*; D000900:Anti-Bacterial Agents; D003132:Commerce / Q000706:statistics & numerical data*; D004363:Drug Utilization; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D013030:Spain / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents