European Surveillance of Antimicrobial Consumption (ESAC): Outpatient quinolone 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 Bǎicus, Gabriel Popescu, Svetlana Ratchina, Roman Kozlov, Viliam Foltán, Milan Cižman, Edurne Lázaro, José Campos, Francisco de Abajo, Ulrica Dohnhammar, Giorgio Zanetti, Peter Davey, Hayley Wickens

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: Data on more than a decade of outpatient quinolone use were collected from 33 European countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC). Methods: For the period 1997-2009, data on outpatient use of systemic quinolones aggregated at the level of the active substance were collected using the Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) method (WHO, version 2011), and expressed in DDD and packages per 1000 inhabitants per day (DID and PID, respectively). Using a classification based on pharmacokinetic and in vitro potency profiles, quinolone use was analysed with regard to trends over time, seasonal variation and composition. Results: Total outpatient quinolone use in 2009 varied by a factor of 7.5 between the country with the highest (Italy, 3.61 DID) and the country with the lowest (the UK, 0.48 DID) quinolone use. The second-generation quinolones accounted for .50% of quinolone use (mainly ciprofloxacin), except for Croatia, where first-generation quinolones (mainly norfloxacin) were mostly used. A significant increase in outpatient quinolone use was found for Europe, as well as a large seasonal variation, which increased significantly over time from 1997 to 2009. Relative use of third-generation quinolones significantly increased over time with respect to the use of second-generation quinolones, while the relative use of both significantly increased with respect to the firstgeneration quinolones. Levofloxacin and moxifloxacin (respiratory quinolones) represented .10% of quinolone outpatient use in 17 countries, with extreme seasonal variation in all countries. Conclusions: There was a substantial increase and change in the pattern of quinolone use between 1997 and 2009, a period during which quinolones that are effective for the treatment of respiratory tract infections were introduced. These quinolones are not the first-line antibiotics for this indication and their use should generally be limited, and quinolones should ideally show no substantial seasonal variation in terms of their use.

Original languageEnglish
Article numberdkr457
JournalJournal of Antimicrobial Chemotherapy
Volume66
Issue numberSUPPL. 6
DOIs
Publication statusPublished - Dec 2011

Fingerprint

Quinolones
Outpatients
Norfloxacin
Levofloxacin
Croatia
Centers for Disease Control and Prevention (U.S.)
Ciprofloxacin

Keywords

  • Ambulatory care
  • Antibiotic use
  • Drug consumption
  • Pharmacoepidemiology

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Adriaenssens, N., Coenen, S., Versporten, A., Muller, A., Minalu, G., Faes, C., ... Wickens, H. (2011). European Surveillance of Antimicrobial Consumption (ESAC): Outpatient quinolone use in Europe (1997-2009). Journal of Antimicrobial Chemotherapy, 66(SUPPL. 6), [dkr457]. https://doi.org/10.1093/jac/dkr457

European Surveillance of Antimicrobial Consumption (ESAC) : Outpatient quinolone 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; Bǎicus, Anda; Popescu, Gabriel; Ratchina, Svetlana; Kozlov, Roman; Foltán, Viliam; Cižman, 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, dkr457, 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, Bǎicus, A, Popescu, G, Ratchina, S, Kozlov, R, Foltán, V, Cižman, M, Lázaro, E, Campos, J, de Abajo, F, Dohnhammar, U, Zanetti, G, Davey, P & Wickens, H 2011, 'European Surveillance of Antimicrobial Consumption (ESAC): Outpatient quinolone use in Europe (1997-2009)', Journal of Antimicrobial Chemotherapy, vol. 66, no. SUPPL. 6, dkr457. https://doi.org/10.1093/jac/dkr457
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 ; Bǎicus, Anda ; Popescu, Gabriel ; Ratchina, Svetlana ; Kozlov, Roman ; Foltán, Viliam ; Cižman, Milan ; Lázaro, Edurne ; Campos, José ; de Abajo, Francisco ; Dohnhammar, Ulrica ; Zanetti, Giorgio ; Davey, Peter ; Wickens, Hayley. / European Surveillance of Antimicrobial Consumption (ESAC) : Outpatient quinolone 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 quinolone use were collected from 33 European countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC). Methods: For the period 1997-2009, data on outpatient use of systemic quinolones aggregated at the level of the active substance were collected using the Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) method (WHO, version 2011), and expressed in DDD and packages per 1000 inhabitants per day (DID and PID, respectively). Using a classification based on pharmacokinetic and in vitro potency profiles, quinolone use was analysed with regard to trends over time, seasonal variation and composition. Results: Total outpatient quinolone use in 2009 varied by a factor of 7.5 between the country with the highest (Italy, 3.61 DID) and the country with the lowest (the UK, 0.48 DID) quinolone use. The second-generation quinolones accounted for .50{\%} of quinolone use (mainly ciprofloxacin), except for Croatia, where first-generation quinolones (mainly norfloxacin) were mostly used. A significant increase in outpatient quinolone use was found for Europe, as well as a large seasonal variation, which increased significantly over time from 1997 to 2009. Relative use of third-generation quinolones significantly increased over time with respect to the use of second-generation quinolones, while the relative use of both significantly increased with respect to the firstgeneration quinolones. Levofloxacin and moxifloxacin (respiratory quinolones) represented .10{\%} of quinolone outpatient use in 17 countries, with extreme seasonal variation in all countries. Conclusions: There was a substantial increase and change in the pattern of quinolone use between 1997 and 2009, a period during which quinolones that are effective for the treatment of respiratory tract infections were introduced. These quinolones are not the first-line antibiotics for this indication and their use should generally be limited, and quinolones should ideally show no substantial seasonal variation in terms of their use.",
keywords = "Ambulatory care, Antibiotic use, Drug consumption, Pharmacoepidemiology",
author = "Niels Adriaenssens and Samuel Coenen and Ann Versporten and Arno Muller and Girma Minalu and Christel Faes and Vanessa Vankerckhoven and Marc Aerts and Niel Hens and Geert Molenberghs and Herman Goossens and Sigrid Metz and Gerhard Fluch and Sofie Vaerenberg and Goossens, {Mathijs Michiel} and Boyka Markova and Andrašević, {Arjana Tambic} and Antonis Kontemeniotis and Jiř{\'i} Vlček and Niels Frimodt-M{\o}ller and Jensen, {Ulrich Stab} and Ly Rootslane and Ott Laius and Jaana Vuopio-Varkila and Outi Lyytikainen and Philippe Cavalie and Winfried Kern and Helen Giamarellou and Anastasia Antoniadou and G. Tern{\'a}k and R. Benk{\'o} and Haraldur Briem and Olafur Einarsson and Robert Cunney and Ajay Oza and Raul Raz and Hana Edelstein and Pietro Folino and Andis Seilis and Uga Dumpis and Rolanda Valinteliene and Marcel Bruch and Michael Borg and Peter Zarb and Stephanie Natsch and Marieke Kwint and Blix, {Hege Salvesen} and Waleria Hryniewics and Anna Olczak-Pienkowska and Malgorzata Kravanja and Tomasz Ozorowski and Mafalda Ribeirinho and Luis Caldeira and Anda Bǎicus and Gabriel Popescu and Svetlana Ratchina and Roman Kozlov and Viliam Folt{\'a}n and Milan Cižman and Edurne L{\'a}zaro and Jos{\'e} Campos and {de Abajo}, Francisco and Ulrica Dohnhammar and Giorgio Zanetti and Peter Davey and Hayley Wickens",
year = "2011",
month = "12",
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journal = "Journal of Antimicrobial Chemotherapy",
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TY - JOUR

T1 - European Surveillance of Antimicrobial Consumption (ESAC)

T2 - Outpatient quinolone 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 - Bǎicus, Anda

AU - Popescu, Gabriel

AU - Ratchina, Svetlana

AU - Kozlov, Roman

AU - Foltán, Viliam

AU - Cižman, 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 quinolone use were collected from 33 European countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC). Methods: For the period 1997-2009, data on outpatient use of systemic quinolones aggregated at the level of the active substance were collected using the Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) method (WHO, version 2011), and expressed in DDD and packages per 1000 inhabitants per day (DID and PID, respectively). Using a classification based on pharmacokinetic and in vitro potency profiles, quinolone use was analysed with regard to trends over time, seasonal variation and composition. Results: Total outpatient quinolone use in 2009 varied by a factor of 7.5 between the country with the highest (Italy, 3.61 DID) and the country with the lowest (the UK, 0.48 DID) quinolone use. The second-generation quinolones accounted for .50% of quinolone use (mainly ciprofloxacin), except for Croatia, where first-generation quinolones (mainly norfloxacin) were mostly used. A significant increase in outpatient quinolone use was found for Europe, as well as a large seasonal variation, which increased significantly over time from 1997 to 2009. Relative use of third-generation quinolones significantly increased over time with respect to the use of second-generation quinolones, while the relative use of both significantly increased with respect to the firstgeneration quinolones. Levofloxacin and moxifloxacin (respiratory quinolones) represented .10% of quinolone outpatient use in 17 countries, with extreme seasonal variation in all countries. Conclusions: There was a substantial increase and change in the pattern of quinolone use between 1997 and 2009, a period during which quinolones that are effective for the treatment of respiratory tract infections were introduced. These quinolones are not the first-line antibiotics for this indication and their use should generally be limited, and quinolones should ideally show no substantial seasonal variation in terms of their use.

AB - Background: Data on more than a decade of outpatient quinolone use were collected from 33 European countries within the European Surveillance of Antimicrobial Consumption (ESAC) project, funded by the European Centre for Disease Prevention and Control (ECDC). Methods: For the period 1997-2009, data on outpatient use of systemic quinolones aggregated at the level of the active substance were collected using the Anatomical Therapeutic Chemical (ATC)/defined daily dose (DDD) method (WHO, version 2011), and expressed in DDD and packages per 1000 inhabitants per day (DID and PID, respectively). Using a classification based on pharmacokinetic and in vitro potency profiles, quinolone use was analysed with regard to trends over time, seasonal variation and composition. Results: Total outpatient quinolone use in 2009 varied by a factor of 7.5 between the country with the highest (Italy, 3.61 DID) and the country with the lowest (the UK, 0.48 DID) quinolone use. The second-generation quinolones accounted for .50% of quinolone use (mainly ciprofloxacin), except for Croatia, where first-generation quinolones (mainly norfloxacin) were mostly used. A significant increase in outpatient quinolone use was found for Europe, as well as a large seasonal variation, which increased significantly over time from 1997 to 2009. Relative use of third-generation quinolones significantly increased over time with respect to the use of second-generation quinolones, while the relative use of both significantly increased with respect to the firstgeneration quinolones. Levofloxacin and moxifloxacin (respiratory quinolones) represented .10% of quinolone outpatient use in 17 countries, with extreme seasonal variation in all countries. Conclusions: There was a substantial increase and change in the pattern of quinolone use between 1997 and 2009, a period during which quinolones that are effective for the treatment of respiratory tract infections were introduced. These quinolones are not the first-line antibiotics for this indication and their use should generally be limited, and quinolones should ideally show no substantial seasonal variation in terms of their use.

KW - Ambulatory care

KW - Antibiotic use

KW - Drug consumption

KW - Pharmacoepidemiology

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