European Surveillance of Antimicrobial Consumption (ESAC): Outpatient cephalosporin use in Europe (1997-2009)

Ann Versporten, Samuel Coenen, Niels Adriaenssens, 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, Gábor Ternák, Ria Benko, 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: Article

41 Citations (Scopus)


Background: Data on 13 years of outpatient cephalosporin 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), and analysed in detail. Methods: For the period 1997-2009, data on outpatient use of systemic cephalosporins 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 per 1000 inhabitants per day (DID). For detailed analysis of trends over time, seasonal variation and composition of outpatient cephalosporin use in 33 European countries, we distinguished between first-generation (J01DB), second-generation (J01DC), thirdgeneration (J01DD) and fourth-generation (J01DE) cephalosporins. Results: Total outpatient cephalosporin use in 2009 varied from 8.7 DID in Greece to 0.03 DID in Denmark. In general, use was higher in Southern and Eastern European countries than in Northern European countries. Total outpatient cephalosporin use increased over time by 0.364 (SD 0.473) DID between 1997 and 2009. Cephalosporin use increased for half of the countries. Low-consuming Northern European countries and the UK further decreased their use. Second-generation cephalosporins increased by >20% in seven countries (mainly cefuroxime), coinciding with a decrease in first-generation cephalosporins. Substantial parenteral use of third-generation substances (mainly ceftriaxone) was observed in France, Italy and the Russian Federation. Conclusions: Since 1997, the use of the older (narrow-spectrum) cephalosporins decreased in favour of the newer (i.e. broad-spectrum) cephalosporins in most countries. Extreme variations between European countries in cephalosporin use over time suggest that they are to a large extent inappropriately used.

Original languageEnglish
Article numberdkr455
Pages (from-to)vi25-vi35
JournalJournal of Antimicrobial Chemotherapy
Issue numberSUPPL. 6
Publication statusPublished - dec. 2011

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'European Surveillance of Antimicrobial Consumption (ESAC): Outpatient cephalosporin use in Europe (1997-2009)'. Together they form a unique fingerprint.

  • Cite this

    Versporten, A., Coenen, S., Adriaenssens, N., Muller, A., Minalu, G., Faes, C., Vankerckhoven, V., Aerts, M., Hens, N., Molenberghs, G., Goossens, H., Metz, S., Fluch, G., Vaerenberg, S., Goossens, M. M., Markova, B., Andrašević, A. T., Kontemeniotis, A., Vlček, J., ... Wickens, H. (2011). European Surveillance of Antimicrobial Consumption (ESAC): Outpatient cephalosporin use in Europe (1997-2009). Journal of Antimicrobial Chemotherapy, 66(SUPPL. 6), vi25-vi35. [dkr455].