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Review
. 2021 Jul 26;76(12 Suppl 2):ii22-ii29.
doi: 10.1093/jac/dkab174.

Consumption of cephalosporins in the community, European Union/European Economic Area, 1997-2017

Ann Versporten  1 , Robin Bruyndonckx  1   2 , Niels Adriaenssens  1   3 , Niel Hens  2   4 , Dominique L Monnet  5 , Geert Molenberghs  2   6 , Herman Goossens  1 , Klaus Weist  5 , Samuel Coenen  1   3 ; ESAC-Net study group
Collaborators, Affiliations
Review

Consumption of cephalosporins in the community, European Union/European Economic Area, 1997-2017

Ann Versporten et al. J Antimicrob Chemother. .

Abstract

Objectives: Data on cephalosporin consumption in the community were collected from 30 EU/EEA countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main subgroups of cephalosporins.

Methods: For the period 1997-2017, data on consumption of cephalosporins (i.e. first-, second-, third- and fourth-generation cephalosporins; ATC subgroups J01DB, J01DC, J01DD and J01DE, respectively) in the community and aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Cephalosporin consumption was analysed based on ATC-4 subgroup, and presented as trends, seasonal variation, presence of change-points and compositional changes.

Results: In 2017, cephalosporin consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 285 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Cephalosporin consumption did not change significantly between the first quarter of 1997 and the last quarter of 2017. Seasonal variation decreased significantly over time. Proportional consumption of second- and third-generation cephalosporins significantly increased over time compared with that of first-generation cephalosporins, and proportional consumption of fourth-generation cephalosporins significantly decreased compared with that of second- and third-generation cephalosporins.

Conclusions: Despite considerable variation between countries in the composition of cephalosporin consumption and trends over time, a significant shift towards consumption of more broad-spectrum cephalosporins in the community was observed across the EU/EEA during 1997-2017.

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Figures

Figure 1.
Figure 1.
Consumption of cephalosporins (ATC J01DB, J01DC, J01DD and J01DE) in the community, expressed in DDD (ATC/DDD index 2019) per 1000 inhabitants per day, 30 EU/EEA countries, 2017. For Czechia, 2015 data are used. For Slovakia, 2016 data are used. For Cyprus and Romania, total care data, community and hospital sector combined, are used.
Figure 2.
Figure 2.
Consumption of cephalosporins (ATC J01DB, J01DC, J01DD and J01DE combined) in the community, expressed in packages per 1000 inhabitants per day, 20 EU/EEA countries, 2017. For Czechia, 2015 data are used. For Slovakia, 2016 data are used. For Cyprus and Romania, total care data, i.e. community and hospital sector combined, are used.
Figure 3.
Figure 3.
Estimated trend (solid line) and linear trend (dashed line) of consumption of cephalosporins (ATC J01DB, J01DC, J01DD and J01DE) in the community based on quarterly data, 25 EU/EEA countries, 1997–2017. β0, predicted consumption in the first quarter of 1997; β1, predicted increase (if positive)/decrease (if negative) in consumption per quarter; β2, predicted difference in slope after versus before the first change-point; β3, predicted difference in slope after versus before the second change-point; β4, predicted difference in slope after versus before the third change-point; β0S, predicted amplitude of the upward winter and downward summer peak in consumption; β1S, predicted increase (if positive)/decrease (if negative) of the amplitude of the upward winter and downward summer peak in consumption per quarter; δ, shift in timing of the upward winter and downward summer peak from one year to another. An asterisk indicates the result is statistically significant at significance level 0.05.
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References

    1. European Centre for Disease Prevention and Control (ECDC). European Surveillance of Antimicrobial Consumption Network (ESAC-Net). https://www.ecdc.europa.eu/en/about-us/partnerships-and-networks/disease....
    1. WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. https://www.whocc.no/atc_ddd_index_and_guidelines/guidelines/.
    1. Coenen S, Ferech M, Dvorakova K. et al.European Surveillance of Antimicrobial Consumption (ESAC): outpatient cephalosporin use in Europe. J Antimicrob Chemother 2006; 58: 413–7. - PubMed
    1. Versporten A, Coenen S, Adriaenssens N. et al.European Surveillance of Antimicrobial Consumption (ESAC): outpatient cephalosporin use in Europe (1997–2009. ). J Antimicrob Chemother 2011; 66Suppl 6: vi25–35. - PubMed
    1. Bruyndonckx R, Adriaenssens N, Versporten A. et al.Consumption of antibiotics in the community, European Union/European Economic Area, 1997–2017. J Antimicrob Chemother 2021; 76Suppl 2: ii7–ii13. - PMC - PubMed

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