Outpatient Utilization of Systemic Antibiotics in the Republic of Srpska

Abstract

Introduction. Information on antibiotic utilization in the Republic of Srpska is limited.
The aim of this study was to analyze antibiotic utilization in the community from 2007
to 2011 and to compare this data with antibiotic use in other European countries.
Materials and Methods. We did a population-based study to analyze systemic
antibiotic utilization by an outpatient population using Anatomical Therapeutic
Chemical/Defi ned Daily Dose methodology. The results were expressed as the
defi ned daily dose (DDD) per 1000 inhabitants per day. The data were obtained from
the annual reports of the Agency for Drugs and Medical Devices of the Republic of
Srpska and Public Health Institute.
Results. Outpatient use of systemic antibiotics ranged between 21.51 DDD in the
year with the highest use (2010) and 17.01 DDD in the year with the lowest use (2011).
Penicillins were the most frequently prescribed antibiotic group, and amoxicillin was
the most frequently prescribed drug. Cefalexin was the most frequently prescribed
cephalosporin. Increased use of a second-generation cephalosporin, cefuroxime
constituted almost a third of cefalexin consumption in 2011. Second-generation
quinolones, mostly ciprofl oxacine, accounted for about 70% of total quinolones
consumption, with rising third-generation drugs also in proportion to the increasing
use. Erythromycine was the most frequently used macrolide, followed by long-acting
azithomycin.
Conclusion. Outpatient use of systemic antibiotics in the Republic of Srpska, at
about 19 DDD, does not exceed that in Europe. As in other European countries, a
shift between generations of drugs was noted for antibiotic use. Additional studies,
including monitoring of seasonal variation impact on antibiotic use, are needed.