Surveillance of outpatient antibiotic consumption in Spain according to sales data and reimbursement data

• Published in: Journal of antimicrobial chemotherapy Vol. 60; no. 3; pp. 698 - 701
• Main Authors: Campos, José, Ferech, Matus, Lázaro, Edurne, de Abajo, Francisco, Oteo, Jesús, Stephens, Peter, Goossens, Herman
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2007; Oxford Publishing Limited (England)
• Subjects: Ambulatory Care - economics; Ambulatory Care - statistics & numerical data; Anti-Bacterial Agents; antibiotic resistance; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Commerce - statistics & numerical data; Drug resistance; Drug Utilization; Epidemiology; ESAC; European Surveillance of Antimicrobial Consumption; Humans; Insurance, Health, Reimbursement - statistics & numerical data; Medical sciences; National Health Programs - economics; National Health Programs - statistics & numerical data; Pharmacology. Drug treatments; Population Surveillance - methods; Prescription drugs; Sales; self-antibiotic medication; Spain - epidemiology; Trends; Europe; Spain; ESAC; European Surveillance of Antimicrobial Consumption; self-antibiotic medication; antibiotic resistance; Consumption; Human; Nutrition; Antimicrobial agent; Resistance; Self prescription; Antibiotic; Diet; Surveillance; Ambulatory; Antibacterial agent
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkm248

Objectives National data on antibiotic consumption are needed in order to interpret trends in antibiotic resistance. We compared antibiotic prescription reimbursement data and sales data in Spain. Methods Data covering the years 2002, 2004 and 2005 were examined. Reimbursement data for ambulatory care were provided by the Spanish Agency for Medicines and Healthcare Products and sales data by International Medical Statistics Health. Quantities were standardized using the defined daily dose per 1000 inhabitants per day (DID) in accordance with the anatomical therapeutic classification. Results Sales data increased from 26.33 DID in 2002 to 28.12 DID in 2004 and 28.93 DID in 2005. Estimates based on equivalent reimbursement data were ~30% lower and increased from 18.01 DID in 2002 to 18.48 DID in 2004 and 19.29 DID in 2005. The differences were greatest for amoxicillin, amoxicillin/clavulanic acid, clarithromycin and cefuroxime. Conclusions Antibiotic consumption as estimated from reimbursement data is substantially less than that from sales data. This finding has major implications for national surveillance of antibiotic consumption.