IMPACT OF REGULATORY MEASURES ON ANTIBIOTIC SALES IN CHILE. Bavestrello L, Cabello A. Gustavo Fricke Hospital.Viña del Mar.CHILE

Introduction Antibiotics are drugs used in the prevention and treatment of infections caused by pathogenus microorganisms. Its use must be linked to a medical prescription since they can present adverse reactions and its use is related to an increase of bacterial resistance. There is a relation between antibiotic consumption in the community and the appearance and spreading of resistance

Introduction Therefore, the indiscriminate use of antibiotics increases the appearance of bacterial resistence and forces the use of more expensive alternatives. The Chilean Ministry of Health is regulating the consumption of antibiotics since September 1999, as a strategy to encourage the rational use of antibiotics.

OBJECTIVE To study the impact of the 1999 regulatory measures on antibiotic sales implemented by the Chilean Ministry of Health in community pharmacies, determined in three ways: in DDD/1000 inh.-day as a consumption unit, in sale units, expressed in USD, during seven years, from 1996 to 2002.

METHOD 1) Census Population Data of Chile. 2) Annual sales data for antibiotics I.M.S. 1996 to 2002. 3) Definition of the consumption unit used: DDD/1000 inhabitants-day. 4) Calculation of the Nº of DDD sold for each antibiotic: DDD/1000 inhabitants/day = sold grams x 1000 DDD spe.x Nºdays x Population

The basis of action Plan to assure antibiotics rational use: Intervention: The basis of action Plan to assure antibiotics rational use: The antibiotic use must respond to a diagnosis and medical prescription. The dispense of the antibiotics must take place in the presence of a prescription. The condition of sale written in the package of each antibiotic pharmaceutical product must be executed in all circunstance and at any moment.(Document 4C/4619, September 1999)

Contents of the action plan: Fulfilment of the antimicrobial sale restriction (sale only with prescription). Population Information: leaflets and posters in community pharmacies. Extensive coverage on radio and television news. Education campaign. Test the compliance of the sale restriction.

Results There was an important reduction in consumption, expressed as DDD/1000 inh.-day, after the introduction of the regulatory measures for the most oral antibiotic groups. There was also an important fall in sale units and also in sales expressed in US dollars, after 1999. This tendency is mainteined during the last 3 years.

This is where a large graphic or chart can go.

Graph 2:Units of packages sold from 1988 to 2002.

Graph 3:Units of packages sold from 1988 to 2002.

Table 1:Sales of orals antibiotic in USD.(Mill$) Year 1996 1997 1998 1999 2000 2001 2002 USD 37,6 45,8 38,9 32,1 29,4 26,1

CONCLUSIONS The regulatory measures in 1999 had an important impact in the community’s antibiotic consumption in Chile. The regulatory measures contributed to a considerable saving of money in the community due to a decrease in antibiotic use. The success of the long term program depends on the compliance, maintenance, supervision and control of these measures by involved parts, including physicians, prescriptors, pharmacist and community in general.