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Trends in the Hospital Sector Consumption of the Reserve Group of Antibiotics as Defined in the WHO AWaRe Classification, EU/EEA, 2010-2018: A Cross-Sectional, Observational Study
19 Pages Posted: 12 Oct 2021
More...Abstract
Background: The latest published World Health Organization 21 st Model list of Essential Medicines updated the AWaRe (Access, Watch Reserve) classification of antibiotics. The aim of this study was to explore trends and quantify the consumption of the Reserve group of antibiotics in European Union/European Economic Area (EU/EEA) countries.
Methods: Data on antimicrobial consumption in the hospital sector in EU/EEA countries for 2010-2018 were obtained from the European Centre for Disease Prevention and Control (ECDC). Consumption of antibacterials for systemic use (ATC group J01) were included in the analysis and expressed as defined daily doses (DDD) per 1,000 inhabitants per day. Reserve antibiotics were defined as in the AWaRe classification.
Findings: EU/EEA average hospital sector consumption of Reserve antibiotics significantly increased from 0·017 to 0·050 DDD per 1,000 inhabitants per day over the study period (p=0·004). This significant increase was observed in 15 EU/EEA countries. Four antibiotics (tigecycline, colistin, linezolid and daptomycin) constituted most of this consumption. In 2018, both the absolute and relative (i.e. % of total hospital sector) consumption of Reserve of antibiotics varied considerably (up to 42-fold) between EU/EEA countries (from 0·004 to 0·155 DDD per 1,000 inhabitants per day and from 0·2% to 9·3%, respectively).
Interpretation: This study showed a significantly increasing trend in the EU/EEA in the consumption of Reserve antibiotics, which are regarded as last-resort treatment options. The substantial variation between countries may reflect the burden of infections with multidrug-resistant bacteria. The study results could guide national actions or optimise the use of Reserve antibiotics.
Funding Information: None.
Declaration of Interests: Ria Benko was supported by the János Bólyai research scholarship of the Hungarian Academy of Sciences. Other authors declare no competing interests.
Keywords: antibiotic consumption, AWaRe classification, Reserve antibacterials, hospital care sector, inpatient care, population-level data, antibiotic stewardship, Europe, ATC, DDD per 1, 000 inhabitant-days
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