title: Differences in outpatient antibiotic use between a Spanish region and a Nordic country.
abstract: BACKGROUND
  Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present study was to describe and compare antibiotic prescribing in Primary Care in Denmark and Aragón (a North-eastern Spanish region).
  
  
  METHODS
  Outpatient antibiotic prescription data (2010) were obtained from the National Institute for Health Data and Disease Control (Denmark), and the Information System on Medication Consumption in Aragón. The consumption of antibiotics (ATC J01) was analyzed from the prescription rates and the number of defined daily dose (DDD) per 1000 inhabitants/day (DID).
  
  
  RESULTS
  The rate of antibiotic prescription in 2010 in Aragón was greater than in Denmark (407 compared to 315 exposed individuals/1000 inhabitants). There were significant differences as regards overall consumption of antibiotics (23.2 DID in Aragón and 17.0 DID in Denmark), as well as the therapeutic group selection. There was an elevated use of broad spectrum penicillins, quinolones and cephalosporins in the Spanish region while, in Denmark, the most-consumed antibiotic was narrow spectrum penicillin.
  
  
  CONCLUSIONS
  The use of antibiotics in the Spanish region is very high, and there are marked differences in the choice of drug between this region and Denmark. Interventions are needed that promote the rational use of these drugs to reduce potential bacterial resistance, and to avoid unnecessary risks to patients.
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain. Electronic address: smalo@unizar.es.
authors.forename: Sara
authors.initials: S
authors.lastname: Malo-Fumanal
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Rabanaque-Hernández
authors.affiliation: Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Feja-Solana
authors.affiliation: Servicio de Farmacia de Atención Primaria, Servicio Aragonés de Salud, Zaragoza, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Lallana-Alvarez
authors.affiliation: Servicio de Farmacia, Servicio Aragonés de Salud, Zaragoza, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Armesto-Gómez
authors.affiliation: Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Bjerrum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013030:Spain; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibacterial prescription; Atención primaria; Comparación internacional; General practice; International comparison; Prescripción antibiótica