Tobacco products in the European Union Common Entry Gate (EU-CEG): A tool for monitoring the EU tobacco products directive.

Introduction: Under the European Union (EU) Tobacco Products Directive (2014/40/EU) (TPD), manufacturers and importers of tobacco products are required to report information to the European Commission (EC) and Member States (MS) on products intended to be placed on the market. We describe the distribution of notifications to the EU Common Entry Gate (EU-CEG) and identify key fields for improvement on reporting cigarettes or roll-your-own (RYO) tobacco.

Methods: A cross-sectional analysis of secondary data reported in the EU-CEG was conducted for tobacco products notified within EU-CEG between June 2016 and October 2019 for 12 EU MS.

Socioeconomic determinants of outpatient antibiotic use in Europe.

Objectives: Outpatient antibiotic consumption widely varies across Europe. The investigation of the causes of such variation may help to identify interventions that would improve the efficient use of antibiotics. The aim of this study was to assess the impact of socioeconomic determinants and the role played by information about bacterial resistance.

Antimicrobial drug use and resistance in Europe.

Our study confronts the use of antimicrobial agents in ambulatory care with the resistance trends of 2 major pathogens, Streptococcus pneumoniae and Escherichia coli, in 21 European countries in 2000-2005 and explores whether the notion that antimicrobial drug use determines resistance can be supported by surveillance data at national aggregation levels. The data obtained from the European Surveillance of Antimicrobial Consumption and the European Antimicrobial Resistance Surveillance System suggest that variation of consumption coincides with the occurrence of resistance at the country level. Linear regression analysis showed that the association between antimicrobial drug use and resistance was specific and robust for 2 of 3 compound pathogen combinations, stable over time, but not sensitive enough to explain all of the observed variations.

Outpatient antibiotic use in the four administrations of the UK: cross-sectional and longitudinal analysis.

Objectives: We compared community antibiotic use in the four administrations of the UK with that in other European countries.

Patients And Methods: A cross-sectional analysis of 24 European countries and UK administrations in 2005 with longitudinal analysis of data from Belgium and UK from 1997 was performed. Antibiotic use was measured as defined daily doses per 1000 inhabitants per day (DID) or as prescriptions or packages per 1000 inhabitants per day (PID) with aggregate data from patients who received antibiotics in the primary care or outpatient setting.

Antibiotic consumption in southern and eastern Mediterranean hospitals: results from the ARMed project.

Objectives: The intensity of antibiotic use in hospital settings is recognized as possibly the most important factor for the selection of antimicrobial resistance. Hospitals are therefore being encouraged to undertake surveillance and benchmarking of antimicrobial consumption patterns with a view to identify and rectify possible evidence of overuse or misuse.

Methods: As part of the ARMed project, antibiotic use in 25 hospitals from the southern and eastern Mediterranean countries of Cyprus, Egypt, Jordan, Lebanon, Malta, Tunisia and Turkey was assessed prospectively for 24 months during the years 2004-05.

Increasing telithromycin resistance among Streptococcus pyogenes in Europe.

Objectives: To assess changes in macrolide and ketolide resistance among Streptococcus pyogenes in Europe and to examine the relationship of resistance to antimicrobial usage.

Methods: Clinical S. pyogenes isolates were collected from Denmark, Finland, France, Germany, Italy, Netherlands, Norway, Spain, Sweden, UK, Croatia, Hungary, Poland, Slovak Republic and Slovenia during 2002-03 (n = 2165) and 2004-05 (n = 2333).

European Surveillance of Antimicrobial Consumption (ESAC): quality indicators for outpatient antibiotic use in Europe.

Background And Objective: Indicators to measure the quality of healthcare are increasingly used by healthcare professionals and policy makers. In the context of increasing antimicrobial resistance, this study aimed to develop valid drug-specific quality indicators for outpatient antibiotic use in Europe, derived from European Surveillance of Antimicrobial Consumption (ESAC) data.

Methods: 27 experts (15 countries), in a European Science Foundation workshop, built on the expertise within the European Drug Utilisation Research Group, the General Practice Respiratory Infections Network, the ESCMID Study Group on Primary Care Topics, the Belgian Antibiotic Policy Coordination Committee, the World Health Organization, ESAC, and other experts.

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

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.

Antimicrobial use in Europe and antimicrobial resistance in Streptococcus pneumoniae.

The study presented here determined the relationship between antimicrobial resistance in Streptococcus pneumoniae and the use of antimicrobial agents in 15 different European countries. Pneumococcal isolates (n = 1974) recovered from patients with community-acquired respiratory tract infections during the winter of 2004-2005 in 15 European countries were characterized. The overall percentages of isolates demonstrating intermediate or complete resistance to penicillin, erythromycin, tetracycline, trimethoprim-sulfamethoxazole (TMP-SMX) and ciprofloxacin were 24, 24.

Comparison of outpatient systemic antibacterial use in 2004 in the United States and 27 European countries.

The European Surveillance of Antimicrobial Consumption (ESAC) project collects data on antibacterial use in Europe, applying the Anatomic Therapeutic Chemical classification system and defined daily dose methodology, as recommended by the World Health Organization. Comparable data for the United States have been collected from IMS Health. The IMS Health sales data, processed according to ESAC methodology, suggest that outpatient antibacterial use in the United States is high (only 3 of 27 European countries used more) and is mainly characterized by a shift towards newer antibiotics.

European Surveillance of Antimicrobial Consumption (ESAC): outpatient quinolone use in Europe.

Background: Data on outpatient quinolone use in Europe were collected from 25 countries within the ESAC project, funded by DG SANCO of the European Commission, using the WHO ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic quinolones aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID). Because a new DDD for levofloxacin was published in the ATC 2004 index (0.

European Surveillance of Antimicrobial Consumption (ESAC): outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe.

Background: Data on outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe were collected from 25 countries within the ESAC project, funded by DG SANCO of the European Commission, using the WHO ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic MLS aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID). Macrolide use was analysed in detail, using a classification based on their mean plasma elimination half-life.

European Surveillance of Antimicrobial Consumption (ESAC): outpatient cephalosporin use in Europe.

Background: Data on outpatient cephalosporin use in Europe were collected from 25 countries within the ESAC project, funded by DG SANCO of the European Commission, using the WHO ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic cephalosporins aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID). Use was analysed in detail, using the new ATC codes J01DB, J01DC, J01DD and J01DE, introduced in the 2005 issue of the WHO ATC index and assigned to the four cephalosporin generations.

European Surveillance of Antimicrobial Consumption (ESAC): outpatient penicillin use in Europe.

Background: Data on outpatient penicillin use in Europe were collected from 25 countries within the ESAC project, funded by DG SANCO of the European Commission, using the WHO ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic penicillins aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID). Of the 'Penicillins' (J01C), outpatient use of narrow-spectrum penicillins (J01CE), broad-spectrum penicillins (J01CA), penicillinase-resistant penicillins (J01CF) and combinations with beta-lactamase inhibitors (J01CR) in 25 European countries was analysed in detail.

European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe.

Background: The ESAC project, granted by DG SANCO of the European Commission, is an international network of surveillance systems, aiming to collect comparable and reliable data on antibiotic use in Europe. Data on outpatient antibiotic use were collected from 34 countries using the ATC/DDD methodology.

Methods: For the period 1997-2003, data on outpatient use of systemic antibiotics aggregated at the level of the active substance were collected and expressed in DDD (WHO, version 2004) per 1000 inhabitants per day (DID).

Antibiotic use in ambulatory care in Europe (ESAC data 1997-2002): trends, regional differences and seasonal fluctuations.

Purpose: The ESAC project (European Study on Antibiotic Consumption) aims to collect antibiotic-use data through a European network of national surveillance systems. This paper reports on the retrospective data collection in ambulatory care for the period 1997-2002.

Methods: Valid data of antibiotic consumption of 24 European countries for 2002 and of 18 countries for the entire 6-year period was classified according to the Anatomical Therapeutic Chemical Classification (ATC) and expressed in defined daily dose (DDD) per 1000 inhabitants per day (DID).

Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997-2002).

Objectives: To collect reliable, comparable and publicly available data on hospital use of antibiotics in Europe aggregated at the national level (1997-2002).

Methods: Consumption data of systemic antibiotics in Anatomical Therapeutic Chemical (ATC) class J01 were collected and expressed in defined daily doses (DDD) per 1000 inhabitants per day. Valid data for 2002 were available for 15 countries, and 6 year trends for 10 countries.

Outpatient use of systemic antibiotics in Croatia.

According to the results of the European Surveillance of Antimicrobial Consumption (ESAC), outpatient antibiotic use in Croatia in 2001 (17.6 DDD per 1000 inhabitants per day) was comparable to the median use of 24 European countries, which were able to deliver valid data.

National campaigns to improve antibiotic use.

High levels of antibiotic consumption are driving levels of bacterial resistance that threaten public health. Nonetheless, antibiotics still provide highly effective treatments for common diseases with important implications for human health. The challenge for public education is to achieve a meaningful reduction in unnecessary antibiotic use without adversely affecting the management of bacterial infections.

The more antibacterial trade names, the more consumption of antibacterials: a European study.

Recent studies have shown large differences in the use of antibacterial agents among European countries. We found a relationship between community consumption and the number of trade names of oral antibacterial agents. This relationship was observed in countries in which consumption was high, as well as in countries in which it was low, and in markets that were opened or were not opened to the sale of copies of original agents.

Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

Background: Resistance to antibiotics is a major public-health problem and antibiotic use is being increasingly recognised as the main selective pressure driving this resistance. Our aim was to assess outpatient use of antibiotics and the association with resistance.

Methods: We investigated outpatient antibiotic use in 26 countries in Europe that provided internationally comparable distribution or reimbursement data, between Jan 1, 1997, and Dec 31, 2002, by calculating the number of defined daily doses (DDD) per 1000 inhabitants per day, according to WHO anatomic therapeutic chemical classification and DDD measurement methodology.

European surveillance of antimicrobial consumption (ESAC): data collection performance and methodological approach.

Background: Europe is a continent with strong public healthcare systems, but diverging antibiotic policies and resistance patterns.

Aims: To describe the performance and methodological approach in a retrospective data collection effort (1997-2001), through an international network of surveillance systems, aiming to collect publicly available, comparable and reliable data on antibiotic use in Europe.

Methods: A central multidisciplinary management team co-ordinated a network of national representatives, liasing with national data providers and bodies responsible for antibiotic policy.