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TEN-YEAR TRENDS IN THE UTILIZATION OF ANTIBIOTICS IN CROATIA ON THE BASIS OF ROUTINELY COLLECTED DATA
DANIJELA DAUS-ŠEBEĐAK
; Specijalistička ordinacija obiteljske medicine „Dr. Danijela Daus-Šebeđak“, Podvinje, Slavonski Brod, Hrvatska
MLADENKA VRCIĆ KEGLEVIĆ
; Zaklada za razvoj obiteljske medicine, Zagreb, Hrvatska
Sažetak
Introduction: Antibiotic resistance is a very important public health problem throughout the world, which is undoubtedly connected with the excessive use of antibiotics. According to monitoring of antibiotic consumption in Europe, Croatia as part of the European Surveillance of Antimicrobial Consumption (ESAC) project was among countries with stable high outpatient antibiotic consumption from 1997 to 2009 and consequently high rates of resistance to many antibiotics. Research
on the use of antibiotics is especially important for family medicine; more than 90% of antibiotics were prescribed outside the hospital, mostly by family physicians (general practitioners). The main aim of this study was to investigate ten-year (2005-2014) trends in antibiotic consumption in Croatia divided into two periods, i.e. during (2005-2009) and after (2010-2014) ESAC study, and to compare the data obtained to those from other EU countries. Methods: The study was
observational, based on routinely collected data from annual reports of the Croatian Agency for Medicinal Products and Medical Devices (HALMED) for the 2005-2014 period. Drug consumption in the reports was presented according to ATC/ DDD methodology and antibiotics were presented under the J code. Results: The results showed an increasing trend of antibiotic consumption until 2009, followed by a stable trend from 2010, with 22-23 daily doses per 1000 inhabitants per day. In comparison to other EU countries, Croatia is a country with high antibiotic consumption. Similar to other countries, penicillins were the most widely used antibiotics, accounting for 48%-55% of total pharmacological consumption. Cephalosporins ranked second with 34%-22%, showing a downward trend of consumption. Macrolides with an upward trend were on the third place and quinolones on the fourth place with a variable trend. However, the structure of consumption
was not comparable to other EU countries. For instance, co-amoxiclav accounted for 53%-70% of the penicillin group, with an upward trend, and azithromycin for about 50% of macrolide consumption, with a varying trend. The increasing trend of consumption of third-generation cephalosporins and quinolones also differed from other EU countries. Consumption of ciprofl oxacin showed an upward trend, and norfl oxacin a downward trend. Conclusion: Although the trend has been stable since 2010, the consumption of antibiotics in Croatia is still higher than in many European countries. Special attention should be paid to the overuse of co-amoxiclav and azithromycin. These data are the reasons to think about introducing systematic interventions aimed at reducing the use of antibiotics.
Ključne riječi
trends in antibiotic consumption; Croatia; ESAC project; co-amoxiclav; azithromycin
Hrčak ID:
193706
URI
Datum izdavanja:
15.2.2018.
Posjeta: 1.545 *