2013 – 2015 and comparison with Europe Abstract N°: ICPIC17-ABS-1761 Outpatient antibiotic consumption in Switzerland : trends over the years 2013 – 2015 and comparison with Europe C. Plüss-Suard, A. Kronenberg, G. Zanetti and the Swiss Centre for Antibiotic Resistance (anresis.ch) Introduction Results Conclusions Surveillance of antibiotic consumption is a key component of antibiotic stewardship activities1. Our objectives were to describe antibiotic consumption in the outpatient setting in Switzerland in the frame of the programme anresis.ch and to compare it to European antibiotic use level. Global antibiotic consumption (5.7 DID in 2013, and 5.5 in 2015, -3%) was relatively low compared with European countries participating to ESAC-Net (20.1 in 2013, and 20.7 in 2015, +3%)2. It was higher in the French- (12.0 and 11.2 DID resp.) and in the Italian-part of Switzerland (11.9 and 11.2 DID resp.) (Fig 1). Combination of penicillins was the most used class in all cantons (31% ± 7%, weighted mean of global use ± standard deviation; ESAC-Net median 24%). Fluoroquinolone use was the second most used class (15% ± 3%; ESAC-Net median 8%) (Fig.2). Global antibiotic consumption was higher in patients aged 18-64 (3.7 DID, 61% of the Swiss outpatient antibiotic use) and > 65 (1.8 DID, 29%) than in children (Fig.3). Global antibiotic use in the quarters 1 and 4 was 20% higher than in the quarters 2 and 3 (Fig.4). Compared with European countries, Switzerland has a relatively low global antibiotic consumption. French- and Italian-speaking part of Switzerland remained higher antibiotic consumers as observed 10 years earlier3. However, global antibiotic consumption is underestimated as a recent survey suggested that half of antibiotic consumers got the drugs directly from their attending physicians (or hospitals)4. Intervention to optimize antibiotic prescribing practices should take regional differences into account. Antibiotics for systemic use (class J01 of WHO Anatomical Therapeutic Chemical system, 2017) were collected over the years 2013-2015 through the billing office of the Swiss Pharmacists’ Association (corresponding to 65% of all pharmacies, extrapolated to 100%). Aggregated data were converted into defined daily doses (DDD) and AB use expressed in DDD per 1000 inhabitants and per day (DID). Methods Fig.3 Proportion of antibiotic consumption according to age category (< 2years, 2-11 years, 12-17 years, 18-64 years and > 65 years) Fig.1 Outpatient antibiotic consumption in Swiss cantons expressed in DDD per 1000 inhabitants and per day over the period 2013 – 2015 Fig.2 Proportion of combinations of penicillins and fluoroquinolones in Swiss cantons in 2015 Combinations of penicillins, incl. beta-lactamase inhibitors (J01CR) Fluoroquinolones (J01MA) Genève Fribourg Tessin Jura Neuchatel Valais Vaud Basel-Stadt Aargau Zürich Schaffhausen Basel-LS Graubünden Bern Solothurn Luzern St. Gallen Appenzell IR Thurgau Zug Schwyz Glarus Nidwalden Obwalden Uri Appenzell AR Switzerland Fig.4 Seasonal variation of outpatient antibiotic consumption over the period 2013 -2015 Switzerland Proportion of total DDD per 1000 inhabitants and per day 1. Dellit et al. Clin Infect Dis. 2007; 44: 159-77. 2. ECDC. ESAC-NET Interactive Database. Available from www.ecdc.europa.eu. 3. Filippini et al. Health Policy. 2006; 78(1): 77-92. 4. DemoScope. Rapport national de l’enquête – résistance aux antibiotiques. 09-2016. Available from www.star.admin.ch. References ?? Acknowledgements Catherine.Pluss@chuv.ch Contact