Prevalence of antibiotic use: A methodological comparison across various European health care data sources

Background: There is widespread concern about possible increases in antibiotic use but comparative data from different European countries on levels of use are lacking. Objectives: This study was designed to measure and understand the variation in antibiotic utilization across seven European health care databases from Denmark, Germany, the Netherlands, Spain and the United Kingdom between 2004 and 2009. Methods: Descriptive analyses were stratified by gender, age and type of antibiotic. Separate analyses were performed to measure the most common underlying indications leading to the prescription of an antibiotic agent. Results: The average yearly period prevalence of antibiotic use between 2004 and 2009 varied from 15 (Netherlands) to 30 (Spain) users per 100 patients, whilst the overall number of prescriptions for antibiotic agents increased. A higher prevalence of antibiotic use by females, the very young (0-9 years) and old (80+) was consistently observed in all databases. The lowest point prevalence was recorded in June and September and ranged from 0.51 (Netherlands) to 1.47 (UK) per 100 patients per day. Twelve (Netherlands) to 49 (Spain) percent of all users were diagnosed with a respiratory tract infection and the most common type of antibiotic drug class in every database were penicillins. Conclusions: Using identical methodology in all 7 EU databases to assess antibiotic use allowed us to compare drug usage patterns across Europe. Our results contribute quantitatively to the overall understanding of the pattern of use of antibiotic agents in different EU countries.