Variation of antibiotic consumption and its correlated factors in Turkey.
BACKGROUND
Presentation of antibiotic utilization data by reliable and comparable analyses constitutes an important way of ensuring rational use of antibiotics. This study aimed to evaluate antibiotic consumption (AC) of Turkey by each city/region and to investigate any association of such consumption with socio-economic factors.


METHODS
For 81 provinces and 12 regions in Turkey, AC data from IMS (Intercontinental Medical Statistics) in 2011 was analyzed in accordance with "ATC/DDD, DID" (Anatomical Therapeutic Chemical/Defined Daily Doses, DID = DDD/1000 inhabitants/day) methodology supported by World Health Organization. Association between provincial AC rates and socio-economic development index (SEDI)-2011 and between regional AC rates and some health indicators were analyzed.


RESULTS
While provincial AC data of Turkey was detected to vary between 17.2 and 55.2 DID (Hakkari and Usak, respectively), regional AC ranged from 28.4 to 48.9 DID (Middle Eastern Anatolia and Western Anatolia, respectively). Mostly consumed antibiotic group among all regions were beta-lactamase inhibitor/penicillin combinations (range: 9.9-17.6 DID). SEDI and AC of each city showed positive correlation (rho = 0.683, p < 0.001). While regional AC was positively associated with percentage of 14-year-old population (p = 0.002) and pharmacist density (p < 0.001), it was negatively associated with physician density (p = 0.038).


CONCLUSIONS
It is remarkable that Turkey, at both provincial and regional levels, exhibits important variations in AC, which is proportional to socio-economic status. Besides, the consumption is found to be closely associated with recognized critical factors of access to healthcare. These findings are expected to provide important insights to the activities promoting rational use of antibiotics.
125. Yil Yahyalar Family Health Center, Turkish Public Health Institution, Ankara, Turkey.
Ayfer
A
Sahin
Department of Medical Pharmacology, Marmara University Faculty of Medicine, Maltepe, Istanbul, Turkey. aakici@marmara.edu.tr.
Ahmet
http://orcid.org/0000-0002-8593-0818
A
Akici
Department of Medical Pharmacology, Marmara University Faculty of Medicine, Maltepe, Istanbul, Turkey.
Volkan
V
Aydin
Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey.
Bahar
B
Melik
Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey.
Mesil
M
Aksoy
Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey.
Ali
A
Alkan
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D012959:Socioeconomic Factors; D014421:Turkey
D000900:Anti-Bacterial Agents
Antibiotic utilization; Defined daily dose; Inhabitants; Rational antibiotic use; Socio-economic factors