European Surveillance of Antimicrobial Consumption (ESAC): Outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009)

Niels Adriaenssens, Samuel Coenen, Ann Versporten, Arno Muller, Girma Minalu, Christel Faes, Vanessa Vankerckhoven, Marc Aerts, Niel Hens, Geert Molenberghs, Herman Goossens, Sigrid Metz, Gerhard Fluch, Sofie Vaerenberg, Mathijs Michiel Goossens, Boyka Markova, Arjana Tambic Andrašević, Antonis Kontemeniotis, Jiří Vlček, Niels Frimodt-MøllerUlrich Stab Jensen, Ly Rootslane, Ott Laius, Jaana Vuopio-Varkila, Outi Lyytikainen, Philippe Cavalie, Winfried Kern, Helen Giamarellou, Anastasia Antoniadou, G. Ternák, R. Benkó, Haraldur Briem, Olafur Einarsson, Robert Cunney, Ajay Oza, Raul Raz, Hana Edelstein, Pietro Folino, Andis Seilis, Uga Dumpis, Rolanda Valinteliene, Marcel Bruch, Michael Borg, Peter Zarb, Stephanie Natsch, Marieke Kwint, Hege Salvesen Blix, Waleria Hryniewics, Anna Olczak-Pienkowska, Malgorzata Kravanja, Tomasz Ozorowski, Mafalda Ribeirinho, Luis Caldeira, Anda Bǎicuş, Gabriel Popescu, Svetlana Ratchina, Roman Kozlov, Viliam Foltán, Milan Čižman, Edurne Lázaro, José Campos, Francisco de Abajo, Ulrica Dohnhammar, Giorgio Zanetti, Peter Davey, Hayley Wickens

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Data on more than a decade of outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe were collected from 33 countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC), using the WHO Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) methodology. Methods: For the period 1997-2009, data on outpatient use of systemic MLS aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2011) per 1000 inhabitants per day (DID). Using a classification based on mean plasma elimination half-life, macrolide use was analysed for trends over time, seasonal variation and composition. Results: Total outpatient MLS use in 2009 varied by a factor of 18 between the countries with highest (11.5 DID in Greece) and lowest (0.6 DID in Sweden) use. MLS use showed high seasonal variation. Short-, intermediateand long-acting macrolides were the most commonly used agents in 2, 25 and 5 countries, respectively (mainly erythromycin, clarithromycin and azithromycin, respectively). In Sweden, mainly lincosamides (clindamycin) were used. Lincosamide use was observed in all countries, while substantial use of a streptogramin was only seen in France (pristinamycin). For Europe, a significant increase in outpatient MLS use was found, as well as a significant seasonal variation, which increased over time from 1997 to 2009. Relative use of longacting macrolides and lincosamides significantly increased over time with respect to intermediate-acting macrolides, and relative use of the latter increased with respect to short-acting macrolides. Conclusions: The observed differences between European countries in the levels of MLS use and the extreme seasonal variations in their use suggest that this subgroup of antibiotics is still prescribed inappropriately in many countries.

Original languageEnglish
Article numberdkr456
JournalJournal of Antimicrobial Chemotherapy
Volume66
Issue numberSUPPL. 6
DOIs
Publication statusPublished - Dec 2011

Fingerprint

Streptogramins
Lincosamides
Macrolides
Outpatients
Sweden
Pristinamycin
Azithromycin
Clarithromycin
Clindamycin
Greece
Erythromycin
Centers for Disease Control and Prevention (U.S.)
France
Half-Life

Keywords

  • Ambulatory care
  • Antibiotic use
  • Drug consumption
  • Pharmacoepidemiology

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

European Surveillance of Antimicrobial Consumption (ESAC) : Outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009). / Adriaenssens, Niels; Coenen, Samuel; Versporten, Ann; Muller, Arno; Minalu, Girma; Faes, Christel; Vankerckhoven, Vanessa; Aerts, Marc; Hens, Niel; Molenberghs, Geert; Goossens, Herman; Metz, Sigrid; Fluch, Gerhard; Vaerenberg, Sofie; Goossens, Mathijs Michiel; Markova, Boyka; Andrašević, Arjana Tambic; Kontemeniotis, Antonis; Vlček, Jiří; Frimodt-Møller, Niels; Jensen, Ulrich Stab; Rootslane, Ly; Laius, Ott; Vuopio-Varkila, Jaana; Lyytikainen, Outi; Cavalie, Philippe; Kern, Winfried; Giamarellou, Helen; Antoniadou, Anastasia; Ternák, G.; Benkó, R.; Briem, Haraldur; Einarsson, Olafur; Cunney, Robert; Oza, Ajay; Raz, Raul; Edelstein, Hana; Folino, Pietro; Seilis, Andis; Dumpis, Uga; Valinteliene, Rolanda; Bruch, Marcel; Borg, Michael; Zarb, Peter; Natsch, Stephanie; Kwint, Marieke; Blix, Hege Salvesen; Hryniewics, Waleria; Olczak-Pienkowska, Anna; Kravanja, Malgorzata; Ozorowski, Tomasz; Ribeirinho, Mafalda; Caldeira, Luis; Bǎicuş, Anda; Popescu, Gabriel; Ratchina, Svetlana; Kozlov, Roman; Foltán, Viliam; Čižman, Milan; Lázaro, Edurne; Campos, José; de Abajo, Francisco; Dohnhammar, Ulrica; Zanetti, Giorgio; Davey, Peter; Wickens, Hayley.

In: Journal of Antimicrobial Chemotherapy, Vol. 66, No. SUPPL. 6, dkr456, 12.2011.

Research output: Contribution to journalArticle

Adriaenssens, N, Coenen, S, Versporten, A, Muller, A, Minalu, G, Faes, C, Vankerckhoven, V, Aerts, M, Hens, N, Molenberghs, G, Goossens, H, Metz, S, Fluch, G, Vaerenberg, S, Goossens, MM, Markova, B, Andrašević, AT, Kontemeniotis, A, Vlček, J, Frimodt-Møller, N, Jensen, US, Rootslane, L, Laius, O, Vuopio-Varkila, J, Lyytikainen, O, Cavalie, P, Kern, W, Giamarellou, H, Antoniadou, A, Ternák, G, Benkó, R, Briem, H, Einarsson, O, Cunney, R, Oza, A, Raz, R, Edelstein, H, Folino, P, Seilis, A, Dumpis, U, Valinteliene, R, Bruch, M, Borg, M, Zarb, P, Natsch, S, Kwint, M, Blix, HS, Hryniewics, W, Olczak-Pienkowska, A, Kravanja, M, Ozorowski, T, Ribeirinho, M, Caldeira, L, Bǎicuş, A, Popescu, G, Ratchina, S, Kozlov, R, Foltán, V, Čižman, M, Lázaro, E, Campos, J, de Abajo, F, Dohnhammar, U, Zanetti, G, Davey, P & Wickens, H 2011, 'European Surveillance of Antimicrobial Consumption (ESAC): Outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009)', Journal of Antimicrobial Chemotherapy, vol. 66, no. SUPPL. 6, dkr456. https://doi.org/10.1093/jac/dkr456
Adriaenssens, Niels ; Coenen, Samuel ; Versporten, Ann ; Muller, Arno ; Minalu, Girma ; Faes, Christel ; Vankerckhoven, Vanessa ; Aerts, Marc ; Hens, Niel ; Molenberghs, Geert ; Goossens, Herman ; Metz, Sigrid ; Fluch, Gerhard ; Vaerenberg, Sofie ; Goossens, Mathijs Michiel ; Markova, Boyka ; Andrašević, Arjana Tambic ; Kontemeniotis, Antonis ; Vlček, Jiří ; Frimodt-Møller, Niels ; Jensen, Ulrich Stab ; Rootslane, Ly ; Laius, Ott ; Vuopio-Varkila, Jaana ; Lyytikainen, Outi ; Cavalie, Philippe ; Kern, Winfried ; Giamarellou, Helen ; Antoniadou, Anastasia ; Ternák, G. ; Benkó, R. ; Briem, Haraldur ; Einarsson, Olafur ; Cunney, Robert ; Oza, Ajay ; Raz, Raul ; Edelstein, Hana ; Folino, Pietro ; Seilis, Andis ; Dumpis, Uga ; Valinteliene, Rolanda ; Bruch, Marcel ; Borg, Michael ; Zarb, Peter ; Natsch, Stephanie ; Kwint, Marieke ; Blix, Hege Salvesen ; Hryniewics, Waleria ; Olczak-Pienkowska, Anna ; Kravanja, Malgorzata ; Ozorowski, Tomasz ; Ribeirinho, Mafalda ; Caldeira, Luis ; Bǎicuş, Anda ; Popescu, Gabriel ; Ratchina, Svetlana ; Kozlov, Roman ; Foltán, Viliam ; Čižman, Milan ; Lázaro, Edurne ; Campos, José ; de Abajo, Francisco ; Dohnhammar, Ulrica ; Zanetti, Giorgio ; Davey, Peter ; Wickens, Hayley. / European Surveillance of Antimicrobial Consumption (ESAC) : Outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009). In: Journal of Antimicrobial Chemotherapy. 2011 ; Vol. 66, No. SUPPL. 6.
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abstract = "Background: Data on more than a decade of outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe were collected from 33 countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC), using the WHO Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) methodology. Methods: For the period 1997-2009, data on outpatient use of systemic MLS aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2011) per 1000 inhabitants per day (DID). Using a classification based on mean plasma elimination half-life, macrolide use was analysed for trends over time, seasonal variation and composition. Results: Total outpatient MLS use in 2009 varied by a factor of 18 between the countries with highest (11.5 DID in Greece) and lowest (0.6 DID in Sweden) use. MLS use showed high seasonal variation. Short-, intermediateand long-acting macrolides were the most commonly used agents in 2, 25 and 5 countries, respectively (mainly erythromycin, clarithromycin and azithromycin, respectively). In Sweden, mainly lincosamides (clindamycin) were used. Lincosamide use was observed in all countries, while substantial use of a streptogramin was only seen in France (pristinamycin). For Europe, a significant increase in outpatient MLS use was found, as well as a significant seasonal variation, which increased over time from 1997 to 2009. Relative use of longacting macrolides and lincosamides significantly increased over time with respect to intermediate-acting macrolides, and relative use of the latter increased with respect to short-acting macrolides. Conclusions: The observed differences between European countries in the levels of MLS use and the extreme seasonal variations in their use suggest that this subgroup of antibiotics is still prescribed inappropriately in many countries.",
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TY - JOUR

T1 - European Surveillance of Antimicrobial Consumption (ESAC)

T2 - Outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009)

AU - Adriaenssens, Niels

AU - Coenen, Samuel

AU - Versporten, Ann

AU - Muller, Arno

AU - Minalu, Girma

AU - Faes, Christel

AU - Vankerckhoven, Vanessa

AU - Aerts, Marc

AU - Hens, Niel

AU - Molenberghs, Geert

AU - Goossens, Herman

AU - Metz, Sigrid

AU - Fluch, Gerhard

AU - Vaerenberg, Sofie

AU - Goossens, Mathijs Michiel

AU - Markova, Boyka

AU - Andrašević, Arjana Tambic

AU - Kontemeniotis, Antonis

AU - Vlček, Jiří

AU - Frimodt-Møller, Niels

AU - Jensen, Ulrich Stab

AU - Rootslane, Ly

AU - Laius, Ott

AU - Vuopio-Varkila, Jaana

AU - Lyytikainen, Outi

AU - Cavalie, Philippe

AU - Kern, Winfried

AU - Giamarellou, Helen

AU - Antoniadou, Anastasia

AU - Ternák, G.

AU - Benkó, R.

AU - Briem, Haraldur

AU - Einarsson, Olafur

AU - Cunney, Robert

AU - Oza, Ajay

AU - Raz, Raul

AU - Edelstein, Hana

AU - Folino, Pietro

AU - Seilis, Andis

AU - Dumpis, Uga

AU - Valinteliene, Rolanda

AU - Bruch, Marcel

AU - Borg, Michael

AU - Zarb, Peter

AU - Natsch, Stephanie

AU - Kwint, Marieke

AU - Blix, Hege Salvesen

AU - Hryniewics, Waleria

AU - Olczak-Pienkowska, Anna

AU - Kravanja, Malgorzata

AU - Ozorowski, Tomasz

AU - Ribeirinho, Mafalda

AU - Caldeira, Luis

AU - Bǎicuş, Anda

AU - Popescu, Gabriel

AU - Ratchina, Svetlana

AU - Kozlov, Roman

AU - Foltán, Viliam

AU - Čižman, Milan

AU - Lázaro, Edurne

AU - Campos, José

AU - de Abajo, Francisco

AU - Dohnhammar, Ulrica

AU - Zanetti, Giorgio

AU - Davey, Peter

AU - Wickens, Hayley

PY - 2011/12

Y1 - 2011/12

N2 - Background: Data on more than a decade of outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe were collected from 33 countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC), using the WHO Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) methodology. Methods: For the period 1997-2009, data on outpatient use of systemic MLS aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2011) per 1000 inhabitants per day (DID). Using a classification based on mean plasma elimination half-life, macrolide use was analysed for trends over time, seasonal variation and composition. Results: Total outpatient MLS use in 2009 varied by a factor of 18 between the countries with highest (11.5 DID in Greece) and lowest (0.6 DID in Sweden) use. MLS use showed high seasonal variation. Short-, intermediateand long-acting macrolides were the most commonly used agents in 2, 25 and 5 countries, respectively (mainly erythromycin, clarithromycin and azithromycin, respectively). In Sweden, mainly lincosamides (clindamycin) were used. Lincosamide use was observed in all countries, while substantial use of a streptogramin was only seen in France (pristinamycin). For Europe, a significant increase in outpatient MLS use was found, as well as a significant seasonal variation, which increased over time from 1997 to 2009. Relative use of longacting macrolides and lincosamides significantly increased over time with respect to intermediate-acting macrolides, and relative use of the latter increased with respect to short-acting macrolides. Conclusions: The observed differences between European countries in the levels of MLS use and the extreme seasonal variations in their use suggest that this subgroup of antibiotics is still prescribed inappropriately in many countries.

AB - Background: Data on more than a decade of outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe were collected from 33 countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC), using the WHO Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) methodology. Methods: For the period 1997-2009, data on outpatient use of systemic MLS aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2011) per 1000 inhabitants per day (DID). Using a classification based on mean plasma elimination half-life, macrolide use was analysed for trends over time, seasonal variation and composition. Results: Total outpatient MLS use in 2009 varied by a factor of 18 between the countries with highest (11.5 DID in Greece) and lowest (0.6 DID in Sweden) use. MLS use showed high seasonal variation. Short-, intermediateand long-acting macrolides were the most commonly used agents in 2, 25 and 5 countries, respectively (mainly erythromycin, clarithromycin and azithromycin, respectively). In Sweden, mainly lincosamides (clindamycin) were used. Lincosamide use was observed in all countries, while substantial use of a streptogramin was only seen in France (pristinamycin). For Europe, a significant increase in outpatient MLS use was found, as well as a significant seasonal variation, which increased over time from 1997 to 2009. Relative use of longacting macrolides and lincosamides significantly increased over time with respect to intermediate-acting macrolides, and relative use of the latter increased with respect to short-acting macrolides. Conclusions: The observed differences between European countries in the levels of MLS use and the extreme seasonal variations in their use suggest that this subgroup of antibiotics is still prescribed inappropriately in many countries.

KW - Ambulatory care

KW - Antibiotic use

KW - Drug consumption

KW - Pharmacoepidemiology

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