European Surveillance of Antimicrobial Consumptionesac (ESAC): Outpatient penicillin 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

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42 Citations (Scopus)


Background: Data on 13 years (1997-2009) of outpatient penicillin use were collected from 33 European countries within the European Surveillance of Antimicrobial Consumption (ESAC) project and analysed in detail. Methods: For the period 1997-2009, data on outpatient use of systemic penicillins 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 penicillin use in 33 European countries, we distinguished between narrow-spectrum penicillins (NSP), broad-spectrum penicillins (BSP), penicillinase-resistant penicillins (PRP) and combinations with β-lactamase inhibitors (COP). Results: Total outpatient penicillin (ATC group J01C) use in 2009 varied by a factor of 3.8 between the countries with the highest (16.08 DID in France) and lowest (4.23 DID in the Russian Federation) use. COP represented 45.8%, BSP 40.7%, NSP 10.8% and PRP 2.6% of total European outpatient penicillin use. Total outpatient penicillin use significantly increased over time by 1.53 (SD 0.71) DID between 1997 and 2009. COP (mainly co-amoxiclav) increased by 2.17 (SD 0.40) DID, which was the result of its absolute increase as well as the observed shift from NSP and BSP towards COP. This increase exceeded 10% in 20 countries, where it coincided with a similar decrease in either BSP (15 countries) or NSP (5 countries). Conclusions: Penicillins represented the most widely used antibiotic subgroup in all 33 participating countries, albeit with considerable variation in their use patterns. For Europe, a continuous increase in overall penicillin use and of COP use was observed during the period 1997-2009.

Original languageEnglish
Article numberdkr454
Pages (from-to)vi13-vi23
JournalJournal of Antimicrobial Chemotherapy
Issue numberSUPPL. 6
Publication statusPublished - dec. 1 2011

ASJC Scopus subject areas

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

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    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 Consumptionesac (ESAC): Outpatient penicillin use in Europe (1997-2009). Journal of Antimicrobial Chemotherapy, 66(SUPPL. 6), vi13-vi23. [dkr454].