title: European Surveillance of Antimicrobial Consumption (ESAC): outpatient use of tetracyclines, sulphonamides and trimethoprim, and other antibacterials in Europe (1997-2009).
abstract: BACKGROUND
  Data on more than a decade of outpatient use of tetracyclines, sulphonamides and trimethoprim, and other antibacterials in Europe were collected from 33 countries as part of the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC).
  
  
  METHODS
  For the period 1997-2009, data on outpatient use of systemic tetracyclines, sulphonamides and trimethoprim, and other antibacterials aggregated at the level of the active substance were collected and expressed in defined daily doses (DDD; WHO, version 2011) per 1000 inhabitants per day (DID). Using the Anatomical Therapeutic Chemical (ATC) classification, trends in the use of tetracyclines (J01A), sulphonamides and trimethoprim (J01E) and other antibacterials (J01X) over time, seasonal variation and composition of use were analysed.
  
  
  RESULTS
  In 2009, the variations in outpatient use of systemic tetracyclines, sulphonamides and trimethoprim, and other antibacterials between countries, and also in the composition of use over time, were huge. For tetracyclines a significant and for sulphonamides and trimethoprim a non-significant decrease in use was observed between 1997 and 2009 in Europe. The seasonal variation in their use significantly decreased over time. For the other antibacterials, no significant changes in the volume of use or its seasonal variation were seen.
  
  
  CONCLUSIONS
  As for all other major antibiotic subgroups, a striking variation in use and composition of use between countries in Europe was observed for outpatient use of tetracyclines, sulphonamides and trimethoprim, and other antibacterials. In combination with the decreasing use, especially of recommended substances, this represents an opportunity not only to reduce antibiotic use but also to improve its quality.
authors.affiliation: Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium. samuel.coenen@ua.ac.be
authors.forename: Samuel
authors.initials: S
authors.lastname: Coenen
authors.forename: Niels
authors.initials: N
authors.lastname: Adriaenssens
authors.forename: Ann
authors.initials: A
authors.lastname: Versporten
authors.forename: Arno
authors.initials: A
authors.lastname: Muller
authors.forename: Girma
authors.initials: G
authors.lastname: Minalu
authors.forename: Christel
authors.initials: C
authors.lastname: Faes
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vankerckhoven
authors.forename: Marc
authors.initials: M
authors.lastname: Aerts
authors.forename: Niel
authors.initials: N
authors.lastname: Hens
authors.forename: Geert
authors.initials: G
authors.lastname: Molenberghs
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends*; D005060:Europe; D006801:Humans; D010045:Outpatients / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology / Q000379:methods; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012621:Seasons; D013223:Statistics as Topic / Q000379:methods; D013449:Sulfonamides / Q000145:classification / Q000627:therapeutic use*; D013752:Tetracycline / Q000145:classification / Q000627:therapeutic use*; D014295:Trimethoprim / Q000145:classification / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D013449:Sulfonamides; D014295:Trimethoprim; D013752:Tetracycline