Antibiotic Treatment

The development of antibiotic resistance is influenced by both the extent and patterns of antibiotic use. Relying on narrow-spectrum antibiotics and minimizing the use of broad-spectrum antibiotics, when possible, can help reduce the prevalence of resistance (1,2). Monitoring the extent of broad-spectrum antibiotic use is essential to promote their appropriate usage.

Note: The Defined Daily Dose (DDD) represents the estimated average maintenance dose per day for a drug used in its primary indication in adults. This standardized unit was established by the World Health Organization (WHO) and is employed to estimate the total consumption of medications classified within the ATC system. The OECD has adopted this definition to facilitate international comparisons. It is important to note that, in accordance with the OECD methodology, antibiotic consumption is quantified based on prescribed formulations. However, within the framework of this program, the calculation was performed based on actual dispensed medications.

The definition of the measure was adopted by the OECD to allow for international comparisons. Second-line antibiotics were defined by the OECD as drugs from the cephalosporin and quinolone classes [ATC code groups J01D (cephalosporins and carbapenems) and J01M (quinolones)] (3). These drugs tend to induce resistance and should not be used for initial treatment of most infections treated in the community. It should be noted that there is a relative contraindication for the use of quinolone-class drugs in infants and young children, meaning that the measure’s definition may underrepresent the use of broad-spectrum antibiotics within the paediatric population. Additionally, no distinction is made between first-generation cephalosporins, which have a narrower spectrum of activity compared to cephalosporins from more advanced generations.