title: Prevalence of antibiotic use: a comparison across various European health care data sources.
abstract: OBJECTIVE
  There is widespread concern about increases in antibiotic use, but comparative data from different European countries on rates of use are lacking. This study was designed to measure and understand the variation in antibiotic utilization across five European countries.
  
  
  METHODS
  Seven European healthcare databases with access to primary care data from Denmark, Germany, the Netherlands, Spain and the UK were used to measure and compare the point and 1-year-period prevalence of antibiotic use between 2004 and 2009. Descriptive analyses were stratified by gender, age and type of antibiotic. Separate analyses were performed to measure the most common underlying indications leading to the prescription of an antibiotic.
  
  
  RESULTS
  The average yearly period prevalence of antibiotic use varied from 15 (Netherlands) to 30 (Spain) users per 100 patients. A higher prevalence of antibiotic use by female patients, the very young (0-9 years) and old (80+ years), was observed in all databases. The lowest point prevalence was recorded in June and September and ranged from 0.51 (Netherlands) to 1.47 (UK) per 100 patients per day. Twelve percent (Netherlands) to forty-nine (Spain) percent of all users were diagnosed with a respiratory tract infection, and the most common type of antibiotic prescribed were penicillin.
  
  
  CONCLUSIONS
  Using identical methodology in seven EU databases to assess antibiotic use allowed us to compare drug usage patterns across Europe. Our results contribute quantitatively to the true understanding of similarities and differences in the use of antibiotic agents in different EU countries.
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Ruth
authors.identifier: http://orcid.org/0000-0001-8934-347X
authors.initials: R
authors.lastname: Brauer
authors.affiliation: Fundación Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Ruigómez
authors.affiliation: Amgen NV, London, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: Downey
authors.affiliation: Epidemiology, Pfizer Ltd, Surrey, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bate
authors.affiliation: Fundación Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Garcia Rodriguez
authors.affiliation: Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Huerta
authors.affiliation: Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Gil
authors.affiliation: Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Madrid, Spain.|Pharmacology Section, Department of Biomedical Sciences II, University of Alcalá (UAH), Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: de Abajo
authors.affiliation: Pharmacology Section, Department of Biomedical Sciences II, University of Alcalá (UAH), Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Requena
authors.affiliation: European Medicines Agency (EMA), London, UK.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Alvarez
authors.affiliation: European Medicines Agency (EMA), London, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: Slattery
authors.affiliation: Faculty of Science, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Mark
authors.identifier: http://orcid.org/0000-0002-5764-5788
authors.initials: M
authors.lastname: de Groot
authors.affiliation: Faculty of Science, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Patrick
authors.initials: P
authors.lastname: Souverein
authors.affiliation: Laegemiddelstyrelsen (Danish Medicines Agency), National Institute for Health Data and Disease Control, Copenhagen, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Hesse
authors.affiliation: Institute of Medical Information Sciences, Biometry, and Epidemiology, Ludwig-Maximilians-Universitaet Muenchen, Munich, Germany.
authors.forename: Marietta
authors.initials: M
authors.lastname: Rottenkolber
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.|Philipp Klee-Institute for Clinical Pharmacology, HELIOS Clinic Wuppertal, Wuppertal, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Schmiedl
authors.affiliation: Faculty of Science, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.|MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK.|School CAPHRI / Maastricht University, Maastricht, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: de Vries
authors.affiliation: Amgen NV, London, UK.
authors.forename: Maurille Feudjo
authors.initials: MF
authors.lastname: Tepie
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Raymond
authors.initials: R
authors.lastname: Schlienger
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Liam
authors.initials: L
authors.lastname: Smeeth
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Douglas
authors.affiliation: Epidemiology, Pfizer Research & Development, New York, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Reynolds
authors.affiliation: Faculty of Science, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Olaf
authors.initials: O
authors.lastname: Klungel
mesh_terms: D000900:Anti-Bacterial Agents; D019992:Databases as Topic; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic agents; descriptive study; international comparisons; pharmacoepidemiology; primary care databases