Use of pharmacy delivery data, both in the community and in hospitals, to describe patterns of antibiotic use in Switzerland and monitor this use over time.
The rise of bacterial resistance to antibiotics has become a major public health concern. Its correlation with the consumption of antibiotics is well established. Since there may be a time lag between the use of antibiotics and a variation in resistance, continuous monitoring of antibiotic consumption might be as important as monitoring resistance. This would allow to better understand the forces that drive the epidemiology of resistance; to gather data to feed models predicting the evolution of resistance; to set up a rationale for the choice of interventions to improve rational antibiotic use; and possibly to measure the impact of these interventions. To date, continuous monitoring of bacterial resistance is being implemented in Switzerland within the NRP49 project " SurvEillance of Antibiotic Resistance in Switzerland" (SEARCH). In contrast, there is no routine monitoring of antibiotic consumption, except market-oriented data of manufacturers’ sales available from a private provider.
The present project proposes to implement a sentinel monitoring of antibiotic use in Switzerland based on pharmacy delivery data. The validity of these data will be compared with the survey of manufacturers’ sales. Hospital pharmacists will provide data on hospital consumption and occupancy. Monitoring in the outpatient setting will be limited to the French-speaking part of Switzerland, were the billing office of the Swiss Society of Pharmacists will provide delivery data of antibiotics prescribed by either physicians who participate physicians-pharmacists quality circles or a random sample of physicians who do not participate to these cercles.
A continuous monitoring provides a picture of the pattern of antibiotic use in Switzerland. It can help to understand determinants of this use - such as the geographical region, hospital size, or type of hospital ward – which is pivotal to implement improvement strategies. Monitoring is also needed to establish a correlation between antibiotic use and bacterial resistance, and predict the evolution of this resistance.