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The Influence of National Policies on Antibiotic Prescribing

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Conclusions

Increasing antimicrobial resistance presents a major threat to public health and has caused great concern worldwide. The problem calls for action at a local and global level. Since antibiotic misuse is considered the major condition for the emergence of resistance, many countries have implemented different policies and interventions for controlling antibiotic use most of the time depending on existing resources and infrastructure. Some are simple, based only on education, others are more extensive taking into consideration all aspects involved in antibiotic prescribing. The results of an antibiotic policy should be judged according to its impact on antimicrobial resistance and quality of prescribing and not solely on cost saving. In these terms some national policies have been successful, others not and for some it is still too early to make any judgment, since they are still in the early phase of implementation. However, the effects of many national policies may not be optimal from a global perspective if countries fail to take account of the cross-border effect of their actions (Smith and Coast, 2002). Therefore, besides national policies, international cooperation is a factor that can play a significant role in the battle against antimicrobial resistance. Specifically for Europe, its expansion with the acceptance of new members, gives the challenging opportunity to collectively tackle antimicrobial resistance. This can be done either by implementing uniform European antibiotic policies, or if it is not feasible, by promoting the close cooperation among the European countries on various relative issues.

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References

  • Baquero, F. and the Task Force of The General Direction for Health Planning of the Spanish Ministry of Health, 1996, Antibiotic Resistance in Spain: What can be done? Clin. Infect. Dis., 23, 819–823.

    CAS  PubMed  Google Scholar 

  • Bauraind, I., Goossens, H., Tulkens, P. M., De Meyere, M., De Mol, P., and Verbist, L., 2001a, A public campaign for a more rational use of antibiotics. 11th European Conference on Clinical Microbiology and Infectious Diseases (ECCMID), Istanbul, Turkey, Poster No 410.

    Google Scholar 

  • Bauraind, I., Van den Bremt I, Bogaert, M., Goossens, H., Mouchet, P., Trefois, P. et al. 2001b, 41st Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, II, 2001, Oral Session LB No 023.

    Google Scholar 

  • Bengoa, E. L., Sanz, M. M., and de Abajo Iglesias F. J., 2002, Evolución del consumo de antibióticos en España, 1985–2000. Med. Clin. (Barc), 118, 561–568.

    Google Scholar 

  • Bergan, T., 2001, Antibiotic usage in Nordic countries. Int. J. Antimicrob. Agents, 18, 279–282.

    CAS  PubMed  Google Scholar 

  • Bonten, M. J., Kullberg, B. J., Filius, P. M., and De Stichting Werkgroep Antibioticabeleid, 2001, Optimizing antibiotics policy in the Netherlands. VI. SWAB advice: No selective decontamination of intensive care patients on mechanical ventilation. Ned. Tijdschr. Geneeskd., 145, 353–357.

    CAS  PubMed  Google Scholar 

  • Bouvenot, G., 1999, French National Institute for observation of prescriptions and consumption of medicines. Prescription and consumption of antibiotics in ambulatory care. Bull. Acad. Natl. Med., 183, 601–613.

    CAS  PubMed  Google Scholar 

  • Branthwaite, A. and Pechere, J. C., 1996, Pan-European survey of patients’ attitudes to antibiotics and antibiotic use. J. Int. Med. Res., 24, 229–238.

    CAS  PubMed  Google Scholar 

  • Bruinsma, N., Filius, P. M. G., De Smet, P. A. G. M., Degener, J., Endtz, Ph., Van den Bogaard, A. E. et al., 2002, Antibiotic usage and resistance in different regions of the Dutch community. Microb. Drug Resist., 8, 209–214.

    Article  CAS  PubMed  Google Scholar 

  • Cars, O., Mölstad, S., and Melander, A., 2001, Variation in antibiotic use in the European Union. Lancet, 357, 1851–1853.

    Article  CAS  PubMed  Google Scholar 

  • Cebotarenco, N., 2001, Moldova: Nongovernmental organizations and antibiotic programmes. In J. L. Avorn, J. F. Barrett, P. G. Davey, S. A. McEwen, T. F. O’Brien, and S. B. Levy (eds.), Alliance for the Prudent Use of Antibiotics. Antibiotic Resistance: Synthesis of recommendations by expert policy groups. WHO/CDS/DRS/ 2001.10, pp. 127–129.

    Google Scholar 

  • Chahwakilian, P., 2000, Politiques d’antibiothérapie à l’ échelon national dans divers pays. Rev. Pneumol. Clin. Suppl, 1, 1S9–1S12.

    Google Scholar 

  • Choutet, P., 2001, Impact of opposable medical references prescription guidelines for antibiotic prescriptions in ambulatory medicine. Therapie, 56, 139–142.

    CAS  PubMed  Google Scholar 

  • Colin, C., Geffroy, L., Maisonneuve, H., Menard, J., Guiraud-Chaumeil, B., Fourquet, F. et al., 1997, Country profile: France. Lancet, 349, 791–797.

    Article  CAS  PubMed  Google Scholar 

  • Contopoulos-Ioannidis, D. G., Koliofoti, I., Koutroumpa, I. C., Giannakakis, I., and Ioannidis, J. P. A., 2001, Pathways for inappropriate dispensing of antibiotics for rhinosinusitis: A randomized trial. Clin. Infect. Dis., 33, 76–82.

    Article  CAS  PubMed  Google Scholar 

  • Danzon, P. M. and Chao, L. W., 2000, Cross-national price differences for pharmaceuticals: How large and why? J. Health Econ., 19, 159–195.

    Article  CAS  PubMed  Google Scholar 

  • Durieux, P., Gaillac, B., Giraudeau, B., Doumenc, M., and Ravaud, P., 2000, Despite financial penalties, French physicians’ knowledge of regulatory practice guidelines is poor. Arch. Fam. Med., 9, 414–418.

    Article  CAS  PubMed  Google Scholar 

  • Ekdahl, K., Hanson, H. B., Mölstad, S., Södeström, Walder, M., and Persson, K., 1998, Limiting the spread of penicillin-rsistant Streptococcus pneumoniae: experiences from the South Swedish Pneumococcal Intervention Project. Microb. Drug Resist., 4: 99–105.

    CAS  PubMed  Google Scholar 

  • ESAC (European Surveillance of Antibiotic Consumption), 2003. In www.ua.ac.be/ESAC.

    Google Scholar 

  • ESGAR (European Study Group on Antibiotic Resistance), 1987, In vitro susceptibility to aminoglycoside antibiotics in blood and urine isolates consecutively collected in twentynine European laboratories. Eur. J. Clin. Microbiol., 6, 378–385.

    Google Scholar 

  • Fijn, R., de Jong-van de Berg, L. T. W., and Brouwers, J. R. B. J., 1999, Rational Pharmacotherapy in The Netherlands: Formulary management in Dutch hospitals. Pharm. World Sci., 21, 74–79.

    Article  CAS  PubMed  Google Scholar 

  • Garratini, L. and Tediosi, F., 2000, A comparative analysis of generics markets in five European countries. Health Policy, 51, 149–162.

    Google Scholar 

  • Giamarellou, H. and Antoniadou, A., 1997, The effect of monitoring of antibiotic use on decreasing antibiotic resistance in the hospital. In Antibiotic Resistance: Origins, Evolution, Selection and Spread. Ciba Found Symp., 207, 76–86.

    CAS  PubMed  Google Scholar 

  • Giamarellou, H., Touliatou, K., Koratzanis, G., Petrikkos, G., Kanellakopoulou, K., Lelekis, M. et al., 1986, Nosocomial consequences of antibiotic usage. Scan. J. Infect. Dis., 49 (Suppl.), 182–188.

    CAS  Google Scholar 

  • Giulani, G., Selke, G., and Garattini, L., 1998, The German experience in reference pricing. Health Policy, 44, 73–85.

    Google Scholar 

  • Gould, I. M., 1996, Hospital antibiotic use and its control—the UK experience. In M. Wolff, A. C. Cremieux, C. Carbon, E. Fachon (eds.), Du bon usage des antibiotiques á l’ hôpital. Paris: Arnette Blackwell, 1996:107–119.

    Google Scholar 

  • Gould, I. M., 2001, United Kingdom: Tackling antibiotic resistance in the UK and Europe. In J. L. Avorn, J. F. Barrett, P. G. Davey, S. A. McEwen, T. F. O’Brien, and S. B. Levy (eds.), Alliance for the Prudent Use of Antibiotics. Antibiotic Resistance: Synthesis of recommendations by expert policy groups. WHO/CDS/DRS/ 2001.10:149–152.

    Google Scholar 

  • Gould, I. M., 2002, Antibiotic policies and control of resistance. Curr. Opin. Infect. Dis., 15, 395–400.

    PubMed  Google Scholar 

  • Gould, I. M. and Jappy, B., 2000, Trends in hospital antimicrobial prescribing after 9 years of stewardship. J. Antimicrob. Chemother., 45, 913–917.

    Article  CAS  PubMed  Google Scholar 

  • Harbarth, S., Albrich, W., Brun-Buisson, C., 2002, Outpatient antibiotic use and prevalence of antibiotic-resistant pneumococci in France and Germany: A sociocultural perspective. Emerg. Infect. Dis., 8, 1460–1467.

    PubMed  Google Scholar 

  • Huttin, C, 1996, A critical review of the remuneration systems for pharmacists. Health Policy, 36, 53–68.

    Article  CAS  PubMed  Google Scholar 

  • Janknegt, R., Monkelbaan, J. F., Stobberingh, E. E., and Wijnands, W. J. A., 1994, Antibiotic policies in Dutch hospitals for the treatment of patients with serious infection. J. Antimicrob. Chemother., 34, 1059–1069.

    CAS  PubMed  Google Scholar 

  • Jenkins, T., 1998, Advice of the economical and social committee on, Antibiotic resistance: A threat for public health. Off. J. Eur. Community, C407(02), 7–17.

    Google Scholar 

  • Keuleyan, E., Gould, I. M., 2001, Key issues in developing antibiotic policies: from an institutional level to Europe-wide. European Study Group on Antibiotic Policy (ESGAP), Subgroup III. Clin. Microbiol. Infect., 7(Suppl. 6), 16–21.

    PubMed  Google Scholar 

  • Krcméry, V., Jeljaszewicz, J., Grzesiowski, P., Hryniewicz, W., Metodiev, K., Stratchounski, L. et al., 2000, National and local antibiotic policies in Central and Eastern Europe. J. Chemother., 12, 471–474.

    PubMed  Google Scholar 

  • Kristinsson, K. G., 1999, Modification of prescribers’ behavior: The Icelandic approach. Clin. Microbiol. Infect., 5, 4S43–4S47.

    Google Scholar 

  • Kristinsson, K. G., Hjalmarsdottir, M. A., and Gudnason, T., 1998, Continued decline in the incidence of penicillin non-susceptible pneumococci in Iceland, [abstract C-22] In 38th ICAAC, San Diego, American Society for Microbiology, 74.

    Google Scholar 

  • Lelekis, M., Pachios, G., Goneos, J., Perdios, J., Gargalianos, P., and Kosmidis, J., 1993, Study of antibiotic use in Greek hospitals. In Recent Advances in Chemotherapy. American Society for Microbiology 1993, p. 107–108.

    Google Scholar 

  • Lelekis, M., Chini, M., Vasilopoulos, J., Gika, M., Tsogas, N., Katsimpris, K. et al. 2003, Study of the acceptance and the use by nosocomial doctors of the “Guide for antimicrobial chemotherapy and prophylaxis for the hospitalized patient”. 6th Hellenic Congress of Infectious Diseases, Athens, Abstract No. 46.

    Google Scholar 

  • Le Pen, C., 1997, Pharmaceutical economy and the economic assessment of drugs in France. Soc. Sci. Med., 45, 635–643

    Article  PubMed  Google Scholar 

  • Levy, S. B., 2001, Antibiotic resistance: Consequences of inaction. Clin. Infect. Dis., 33(Suppl. 3), S124–S129

    CAS  PubMed  Google Scholar 

  • Mölstad, S. and Cars O., 1999, Major change in the use of antibiotics following a national programme: Swedish Strategic programme for the rational use of Antimicrobial agents and surveillance of resistance (STRAMA). Scan. J. Infect. Dis., 31, 191–195

    Google Scholar 

  • Monnet, D. L. and Sørensen, T. L., 1999, Interpreting the effectiveness of a national antibiotic policy and comparing antimicrobial use between countries. J. Hosp. Infect., 43, 239–248.

    Article  CAS  PubMed  Google Scholar 

  • Moro, M. L., Petrosillo, N., and Gandin, C., 2003, Antibiotic policies in Italian hospitals: Still a lot to achieve. Microb. Drug Resist., 9, 219–222.

    Article  CAS  PubMed  Google Scholar 

  • Nagler, J., Peetermans, W., Goosens, H., and Struelens, M., 1999, National Committee for the coordination of antibiotic policy in Belgium: The next step in the fight against antimicrobial resistance. Acta Clin. Belg., 54, 319–320.

    CAS  PubMed  Google Scholar 

  • Nathwani, D., 1999, How do you measure the impact of an antibiotic policy? J. Hosp. Infect., 43 (Suppl.): S265–S268.

    Article  PubMed  Google Scholar 

  • National Disease Surveillance Centre, 2001, A strategy for the control of antimicrobial resistance in Ireland (SARI). Report of the subgroup of the Scientific Advisory Committee of the National Disease Surveillance Centre, Dublin: NDSC, 2001.

    Google Scholar 

  • Pradier, C., Rotily, M., Cavailler, P., Haas, H., Pesce, A., Dellamonica, P. et al., 1999, Factors related to the prescription of antibiotics for young children with viral pharyngitis by general practitioners and pediatricians in southeastern France. Eur. J. Clin. Microbiol. Infect. Dis., 18, 510–514.

    Article  CAS  PubMed  Google Scholar 

  • Rautakorpi, U.-M., Huovinen, P., and Klaukka, T., 1997, Is the duration of antibiotic treatment too long? Suom. Lääkäril., 52, 3228–3230.

    Google Scholar 

  • Rautakorpi, U.-M., Klaukka, T., Honkanen, P., Mäkelä, M., Nikkarinen, T., Palva, E. et al., on behalf of the MIKSTRA Collaborative Study Group, 2001, Antibiotic use by indication: A basis for active antibiotic policy in the community. Scand. J. Infect. Dis., 33: 920–926.

    CAS  PubMed  Google Scholar 

  • Seppälä, H., Klaukka, T., Vuopio-Varkila, J., Muotiala A, Helenius H, Lager K et al., 1997, The effects of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance. New Engl. J. Med., 337, 441–446.

    PubMed  Google Scholar 

  • Smith, R. D. and Coast, J., 2002, Antimicrobial resistance: A global response. Bull. World Health Organ., 80, 126–132.

    PubMed  Google Scholar 

  • Sørensen, T. L. and Monnet, D. L., 2000, Control of antibiotic use in the community: The Danish experience. Infect. Control Hosp. Epidemiol., 21, 387–389.

    PubMed  Google Scholar 

  • Standing Medical Advisory Committee, 1998, The path of least resistance. Department of Health, London.

    Google Scholar 

  • Stobberingh, E. E., Janknegt, R., and Wijnands, G., 1993, Antibiotic guidelines and antibiotic utilization in Dutch hospitals. J. Antimicrob. Chemother., 32, 153–161.

    CAS  PubMed  Google Scholar 

  • Struelens, M. J. and Peetermans, W. E., 1999, The antimicrobial resistance crisis in hospitals calls for multidisciplinary mobilization. Acta Clin. Belg., 54, 2–6.

    CAS  PubMed  Google Scholar 

  • van Kasteren, M. E., Wijnands W. J., Stobberingh, E. E., Janknegt, R., Verbrugh, H. A., and van der Meer, J. W., 1998a, Optimizing antibiotics use in the Netherlands. I. The Netherlands Antibiotics Policy Foundation (SWAB). Ned. Tijdschr. Geneeskd., 142, 949–951.

    PubMed  Google Scholar 

  • van Kasteren, M. E., Wijnands W. J., Stobberingh, E. E., Janknegt, R., and van der Meer, J. W., 1998b, Optimization of the antibiotics policy in the Netherlands.II. SWAB guidelines for the antimicrobial therapy of pneumonia in patients at home and as nosocomial infections. The Netherlands Antibiotic Policy Foundation. Ned. Tijdschr. Geneeskd., 142, 952–956.

    PubMed  Google Scholar 

  • van Kasteren, M. E., Wijnands, W. J., Stobberingh, E. E., Janknegt, R., and van der Meer, J. W., 1998c, Optimizing of antibiotics policy in the Netherlands. III. SWAB guidelines for antimicrobial therapy in adults hospitalized with bronchitis. Foundation Antibiotics Policy Work Group. Ned. Tijdschr. Geneeskd., 142, 2512–2515.

    PubMed  Google Scholar 

  • van Kasteren, M. E., Stobberingh, E. E., Janknegt, R., Wijnands, W. J., and van der Meer, J. W., 1999, Optimizing the antibiotics policy in the Netherlands. IV. SWAB-guidelines for antimicrobial therapy of adults with sepsis in hospitals. Foundation Antibiotics Policy Work Group. Ned. Tijdschr. Geneeskd., 143, 611–617.

    PubMed  Google Scholar 

  • van Kasteren, M. E., Gyssens, I. C., Kullberg, B. J., Bruining, H. A., Stobberingh, E. E., and Goris, R. J., 2000, Optimizing antibiotics policy in the Netherlands. V. SWAB guidelines for perioperative antibiotic prophylaxis. Foundation Antibiotics Policy Team. Ned. Tijdschr. Geneeskd., 144, 2049–2055.

    PubMed  Google Scholar 

  • van Kasteren, M. E., Kullberg, B. J., de Boer, A. S., Mintjes-de Groot, J., and Gyssens, I. C., 2003, Adherence to local hospital guidelines for surgical antimicrobial prophylaxis: A multicenter audit in Dutch hospitals. J. Antimicrob. Chemother., 51, 1389–1396.

    PubMed  Google Scholar 

  • Vatopoulos, A., Kalapothaki V., and Legakis N. J., 1999, An electronic network for the surveillance of antimicrobial resistance in bacterial nosocomial isolates in Greece. The Greek Network for the Surveillance of Antimicrobial Resistance. Bull. World Health Organ., 77, 595–601.

    CAS  PubMed  Google Scholar 

  • Woodhead, M., Gialdoni-Grassi, G., Huchon, G. J., Leophonte, P., Manresa, F., and Schaberg, T., 1996, Use of investigations in lower respiratory tract infection in the community: A European survey. Eur. Respir. J., 9, 1596–1600.

    Article  CAS  PubMed  Google Scholar 

  • Working Party Report, 1994, Hospital antibiotic control measures in the UK. J. Antimicrob. Chemother., 34, 21–42.

    Google Scholar 

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Authors and Affiliations

  1. The General Hospital of Athens “G. Gennimatas”, 154 Messogeion Avenue, Athens, 11527, Greece

    Moyssis Lelekis & Panos Gargalianos

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  1. Moyssis Lelekis
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  2. Panos Gargalianos
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Editors and Affiliations

  1. Aberdeen Royal Infirmary, Foresterhill, UK

    Ian M. Gould

  2. University Hospital Nijmegen, Nijmegen, The Netherlands

    Jos W. M. van der Meer

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Lelekis, M., Gargalianos, P. (2005). The Influence of National Policies on Antibiotic Prescribing. In: Gould, I.M., van der Meer, J.W.M. (eds) Antibiotic Policies. Springer, Boston, MA. https://doi.org/10.1007/0-387-22852-7_28

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