Antibiotic use in ambulatory care in Europe (ESAC data 1997-2002): Trends, regional differences and seasonal fluctuations

Monique M. Elseviers, Matus Ferech, Robert H. Vander Stichele, Herman Goossens, Helmut Mittermayer, Sigrid Metz, Boyka Markova, Arjana Andrasevic, Igor Francetic, Despo Bagatzouni, Jiri Vlcek, Dominique L. Monnet, Annemette Anker Nielsen, Ly Rootslane, Pentti Huovinen, Pirkko Paakkari, Philippe Cavalié, Didier Guillemot, Winfried Kern, Helmut SchroederHelen Giamarellou, Anastasia Antoniadou, Gabor Ternak, Karl Kristinsson, Robert Cunney, Ajay Oza, Raul Raz, Giuseppe Cornaglia, Sandra Berzina, Rolanda Valenteliene, Robert Hemmer, Marcel Bruch, Michael Borg, Peter Zarb, Robert Janknegt, Margreet Filius, Hege Salvesen Blix, Waleria Hryniewicz, Pawel Grzesiowski, Luis Caldeira, Irina Codita, Leonid Stratchounski, Svetlana Ratchina, Viliam Foltan, Tomas Tesar, Milan Cizman, José Campos, Otto Cars, Gunilla Skoog, Sigvard Mölstad, Giuliano Masiero, Serhat Unal, Peter Davey

Research output: Article

83 Citations (Scopus)


Purpose: The ESAC project (European Study on Antibiotic Consumption) aims to collect antibiotic-use data through a European network of national surveillance systems. This paper reports on the retrospective data collection in ambulatory care for the period 1997-2002. Methods: Valid data of antibiotic consumption of 24 European countries for 2002 and of 18 countries for the entire 6-year period was classified according to the Anatomical Therapeutic Chemical Classification (ATC) and expressed in defined daily dose (DDD) per 1000 inhabitants per day (DID). Overall and subgroup comparison of antibiotic consumption over time as well as between geographical clusters was performed. Results: Total use of antibiotics in Europe remained at a median level of 20 DID in the period 1997-2002 with a wide variation between countries ranging from 9.8 DID in The Netherlands to 32.2 DID in France. A substantial increase in subclass consumption of co-amoxiclav and fluoroquinolones was noted while the use of narrow-spectrum penicillins, erythromycin, quinolones and sulfonamides decreased. Total consumption as well as seasonal fluctuations showed remarkable geographical clustering with low consumption and low variation between summer and winter in the North, high consumption patterns in the South and a mixed model in the East. Conclusions: Within the ESAC project, valid time series of antibiotic-use data are publicly available now, enabling to improve the study of determinants of use, the evaluation of governmental antibiotic consumption policies and the investigation of the associated emergence of antibiotic resistance.

Original languageEnglish
Pages (from-to)115-123
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Issue number1
Publication statusPublished - jan. 2007

ASJC Scopus subject areas

  • Epidemiology
  • Pharmacology (medical)

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    Elseviers, M. M., Ferech, M., Vander Stichele, R. H., Goossens, H., Mittermayer, H., Metz, S., Markova, B., Andrasevic, A., Francetic, I., Bagatzouni, D., Vlcek, J., Monnet, D. L., Nielsen, A. A., Rootslane, L., Huovinen, P., Paakkari, P., Cavalié, P., Guillemot, D., Kern, W., ... Davey, P. (2007). Antibiotic use in ambulatory care in Europe (ESAC data 1997-2002): Trends, regional differences and seasonal fluctuations. Pharmacoepidemiology and Drug Safety, 16(1), 115-123.