Evolution of outpatient antibiotic use in Portugal mainland 2000-2009

Isabel Ramalhinho, Mafalda Ribeirinho, Isaura Vieira, Jose Cabrita


Introduction: In the latest years, the increasing resistance to antibiotics has become a serious public health issue. The resistance to antimicrobial agents is multifactorial although several studies have shown that the large use of antibiotics for therapeutical and prophylactic purposes, and particularly their misuse, is one factor that contributes most to this problem.

Aim: To assess the evolution of antibiotic consumption in Portugal, Health Regions and Districts of Portugal, from 2000 to 2009.

Material and Methods: Descriptive observational study using as source of information a database of outpatient antibiotic prescription provided by Infarmed, National Authority of Medicines and Health Products. Antibiotic consumption is estimated up from medical prescription, and expressed in DDD/1000 inhabitants/day (DHD).

Results: From 2000 to 2009 antibiotic total consumption varied between 24,12 DHD and 22,03 DHD, which means a decrease by 8,65%. The use of tetracyclines (J01A), cephalosporins (J01D), sulphonamides (J01E), quinolones (J01M) and other antibacterials (J01B, J01G and J01X) decreased during the aforesaid time period. By contrast, there was an increase in the use of the combination penicilin and beta-lactamases inhibitor, and macrolides (J01F). Between 2000 and 2009 there was a significant decrease in the use of outpatient cephalosporins ( - 43,50%). Most notable is the large reduction of the use of cephalosporins between 2000 and 2009 (-43.50%) and also the decrease in the consumption of quinolones (-15.31%).

Conclusion: Although there has been a decrease in the use of antibiotics in Portugal, their consumption is still high. The current study provides information that may be useful to regional Health Authorities in order to develop educational activities, for the population or health professionals, which can promote the rational use of antibiotics.

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