title: Sales of macrolides, lincosamides, streptogramins, and amoxicillin/clavulanate in the in- and outpatient setting in 10 European countries, 2007-2010.
abstract: Monitoring the use of antibiotics is relevant due to the public health impact of microbial resistance, adverse effects, and costs. We present data on the consumption of macrolides, lincosamides, streptogramins and amoxicillin/clavulanate (AMC) between 2007 and 2010 in the in-and outpatient healthcare setting in 10 European countries provided by IMS Health. Antibiotics were classified according to the anatomical therapeutic chemical classification and consumption was expressed in defined daily doses/1000 inhabitants/day (DIDs). We analysed the number of prescriptions by diagnostic codes between 2008 and 2010, based on the International Classification of Diseases, 10th revision (ICD-10). These ICD-10 codes were grouped into four main categories: respiratory infections, genitourinary infections, other infections and other diagnoses. In 2010, the consumption of macrolides and lincosamides ranged from 0.45 DIDs (Sweden) to 5.46 DIDs (Italy), and from 0.04 DIDs (Denmark) to 1.00 DID (Germany), respectively. Streptogramins were available in France, Germany, Italy, Norway, Spain and United Kingdom with a consumption of <0.001 DID exclusively in the hospital setting. The consumption of AMC ranged from <0.001 DIDs (Norway) to 11.67 DIDs (Spain). During the study period, the consumption of macrolides decreased, the consumption of AMC increased in most of European countries, and lincosamides varied very slightly. Macrolides and AMC were mainly prescribed for respiratory infections in all countries but United Kingdom, where most of the prescriptions were assigned to diagnostic codes not clearly related with an infection. Lincosamides were prescribed for the respiratory infections and other infections groups. There was a wide inter-country variability in the percentage of the prescriptions assigned to each of the diagnostic categories. The inter-country differences in the consumption of these antibiotics and their prescription by diagnostic categories point to an inappropriate use of antibiotics.
authors.affiliation: Fundació Institut Català de Farmacologia, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain.
authors.forename: Pili
authors.initials: P
authors.lastname: Ferrer
authors.affiliation: Fundació Institut Català de Farmacologia, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Clinical Pharmacology, University Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Pharmacology, Toxicology and Clinical Therapeutics, Hospital Universitari Vall d' Hebron, Univ Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Mònica
authors.initials: M
authors.lastname: Sabaté
authors.affiliation: Fundació Institut Català de Farmacologia, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Clinical Pharmacology, University Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Pharmacology, Toxicology and Clinical Therapeutics, Hospital Universitari Vall d' Hebron, Univ Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Ballarín
authors.affiliation: DS&E, Global Clinical Epidemiology, Novartis Farmaceutica S.A., Gran Via Corts Catalanes 764, 08013 Barcelona, Spain ; RTI Health Solutions, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Fortuny
authors.affiliation: Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig-Maximilians Universitaet- Muenchen, Marchioninistrasse 15, 81377 Munich, Germany ; Diabetes Research Group, Medical Department 4, University Hospital Munich, Campus Innenstadt, Ludwig-Maximilians-Universität, Ziemssenstr 1, 80336 Munich, Germany.
authors.forename: Marietta
authors.initials: M
authors.lastname: Rottenkolber
authors.affiliation: Philipp Klee-Institute for Clinical Pharmacology, Helios Klinik Wuppertal, Heusnerstrasse 40, 42283 Wuppertal, Germany ; Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten-Herdecke University, Alfred Herrhausen-Strasse 50, 58448 Witten, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Schmiedl
authors.affiliation: Fundació Institut Català de Farmacologia, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Clinical Pharmacology, University Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Pharmacology, Toxicology and Clinical Therapeutics, Hospital Universitari Vall d' Hebron, Univ Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Joan-Ramon
authors.initials: JR
authors.lastname: Laporte
authors.affiliation: Fundació Institut Català de Farmacologia, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Clinical Pharmacology, University Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08029 Barcelona, Spain ; Department of Pharmacology, Toxicology and Clinical Therapeutics, Hospital Universitari Vall d' Hebron, Univ Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: Ibáñez
keywords: Ambulatory; Antibacterials; Cross-national comparison; Defined daily doses; Drug utilisation; Hospital; Indication; Prescription rates