title: Antibiotic use in Albania between 2011 and 2012.
abstract: BACKGROUND
  Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines.
  
  
  METHODS
  Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned.
  
  
  RESULTS
  In 2011-2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin's were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period.
  
  
  CONCLUSIONS
  This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.
authors.affiliation: Faculty of Pharmacy, University of Medicine, Tirana, Albania. ir_hoxha@hotmail.com.
authors.forename: Iris
authors.initials: I
authors.lastname: Hoxha
authors.forename: Admir
authors.initials: A
authors.lastname: Malaj
authors.forename: Ledjan
authors.initials: L
authors.lastname: Malaj
mesh_terms: D000415:Albania; D000554:Ambulatory Care Facilities; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000592:standards; D004363:Drug Utilization; D006291:Health Policy; D006761:Hospitals; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents