Outpatient antibiotic utilisation in the city of Zagreb in 2005

Abstract number: 1733_593

[Scaron]timac D., Culig J., Vuku[scaron]ic I., [Scaron]ostar Z., Bucalic M.

Objective: According to financial indicators, antibiotics ranked fourth, accounting for a high share of 9.44% in the overall drug utilisation in the City of Zagreb. The aim was to identify the causes of such a high utilisation and distribution within the group of antibiotics (J01).

Methods: Data on the number of packages and wholesale price were obtained from all pharmacies in the City of Zagreb for each individual drug registered in Croatia. Based on these data, the number of defined daily doses (DDD) and DDD per 1000 Zagreb inhabitants per day (DDD/1000/day) in 2005 were calculated for each individual drug at all levels of the Anatomic-Therapeutic-Chemical (ATC) drug classification system.

Results: In the City of Zagreb, total utilisation of antibiotics in 2005 was 34.62 DDD/1000/day, yielding a 16% increase from the preceding year. B-Lactam antimicrobials, penicillins (J01C) accounted for more than a half of total antibiotic utilisation with 17.99 DDD/1000/day. Within J01C group, J01CR subgroup of penicillin combinations including b-lactamase inhibitors accounted for 53%. The entire consumption of the latter referred to a combination of amoxicillin and clavulanic acid, the most frequently prescribed antibiotic in the City of Zagreb with 9.61 DDD/1000/day. The subgroup of broad-spectrum penicillins (J01CA), led by amoxicillin with 4.33 DDD/1000/day, accounted for 25% of penicillin utilisation, followed by J01CE with 21%, J01D with 13.85% (predominated by second generation cephalosporins), J01F with 12.34% (predominated by azithromycin with 2.27 DDD/1000/day), J01A (systemic anti-infective agents) with 7.82% (predominated by doxycycline with 2.71 DDD/1000/day, J01M (quinolones) with 6.23% (predominated by norfloxacin with 1.6 DDD/1000/day), J01E with 4.76%, J01X with 2.61%, and J01G (aminoglycosides) with the lowest rate of 0.42%.

Conclusion: Broad-spectrum antibiotics predominated in the utilisation of antibiotics. Amoxicillin with clavulanic acid accounted for almost one third (28.26%) of antibiotic utilisation in the City of Zagreb, in spite of the guidelines preferring the use of narrow-spectrum antibiotics. The rather frequent empiric prescribing of broad-spectrum antibiotics entails the pending risk of the microorganism resistance associated with an array of unfavourable consequences for both the patients and healthcare system in general, ultimately resulting in treatment cost increase and therapeutic inefficiency.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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