Introduction

Efficacy of antibiotics is threatened globally by the occurrence of resistance. Identifying areas of overuse is of public health interest, as exposure to antibiotics facilitates resistance.

Objectives

Using market research data for 8 European countries to assess savings potential for antibiotics in ambulant care of selected respiratory infections incl. bronchitis and cough, pharyngitis and rhinosinusitis.

Methods

Antibiotic consumption for respiratory infections was derived from IQVIA MIDAS data on indications and antibiotic packages sold in 2019. Average volume of prescriptions was determined based on values for France and Germany. Available assessments on the proportion of viral infections were finally used to estimate the level of avoidable consumption.

Results

The three selected indication groups accounted for almost half of all ambulant antibiotic prescriptions (96.9 million out of 206 million packages across 1 year and overall population of 231.6 million in 8 countries). Vast majority of infections were assessed as viral (bronchitis and cough, 85-95%; pharyngitis, 50-80%; rhinosinusitis, 70-80%), resulting in the identified savings potential of 66.2 to 83.7 million antibiotic packages. Relative to the total number of ambulant antibiotic prescriptions, this reflects a savings potential of 17-19% for bronchitis and cough (35 to 39.2 million packages), 9.6-15.3% for pharyngitis (19.7 to 31.5 million packages), and 5.5-6.3% for rhinosinusitis (11.4 to 13 million packages).

Conclusions

Raising awareness with all stakeholders and promoting appropriate antibiotic-free alternatives for symptomatic therapy will be valuable for reducing consumption and tackling antibiotic resistance.