Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 1)

Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Authors:
Majda Šahman Zaimović, Saša Vukmirović, Nataša Tomić, Nebojša Stilinović, Olga Horvat, Ljiljana Tomić

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Background/Aim. The overuse of antibiotics unnecessarily exposes patients to risk of side effects, encourages reconsulta-tion for similar problems and enhances antimicrobial resis-tance. The use of antibiotics in the year 2011 in Montenegro was high (39.05 Defined Daily Dose – DDD/1,000 inhabi-tants/day), but it was not considered in relation to the frequency of bacterial diseases. The aim of our study was to determine the degree of conformance between the amount of outpatient antibiotic consumption and the reported prevalen-ce of outpatient bacterial infections in the Republic of Mon-tenegro. Methods. Data on the use of antibacterial drugs was obtained from the Agency for Medicines and Medical Devi-ces of Montenegro for the year 2012. The amount of antibio-tics was calculated using the Anatomic Therapeutic Chemical (ATC) DDD methodology. Data on the prevalence of outpa-tient infective disease was obtained from the Health Statistical Yearbook 2012 of Montenegro and it was expressed per 1,000 inhabitants. Results. A total of 30.34 DDD/1,000 inhabi-tants/day of antibiotics in outpatients were prescribed in Montenegro in 2012, with penicillins being most frequently prescribed. Amoxicillin and amoxicillin with clavulanic acid were the most frequently used antibiotics. The prevalence of outpatient bacterial infections was 6,745 cases or 10.87/1,000. The most frequent infections were respiratory tract infecti-ons. Less than 50% of the prescribed amount of antibiotics were prescribed in accordance with national guidelines on treatment of bacterial infections. Conclusion. Use of antibio-tics in Montenegro in 2012 was more than double than necessary according to prevalence of bacterial infections and average duration of treatment. The structure of antibiotics was not in full compliance with the national good practice gu-idelines, but it was in accordance with data on bacterial anti-biotic resistance in outpatient practice. It is necessary to initia-te measures to rationalize the use of antibiotics both in terms of quantity and in terms of the structure of the most used an-tibiotics.