Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T00:24:09.022Z Has data issue: false hasContentIssue false

Control of Antibiotic Use in the Community: The Danish Experience

Published online by Cambridge University Press:  02 January 2015

Thomas Lund Sørensen*
Affiliation:
Research and Development, Statens Serum Institut, Copenhagen, Denmark
Dominique Monnet
Affiliation:
Research and Development, Statens Serum Institut, Copenhagen, Denmark
*
Research and Development, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen, Denmark

Abstract

The selection pressure for antibacterial resistance in the community might not be as high as in hospitals. However, it is generally accepted that it is in the primary healthcare sector that one can achieve the greatest decrease in the total use of antimicrobials. There are significant differences in the overall use of antimicrobials among European countries. On average, 80% to 90% of the total antibiotic use in each country takes place in the primary healthcare sector. Surveillance of the use of antimicrobials is the core for planning interventions and monitoring their effect. These interventions may be implemented for either political, economic, or professional reasons. Often, but not always, political interventions are governmental, and professional interventions are recommendations from professional associations. Examples of interventions at different levels in the Danish healthcare system, from the general practitioner to legislation by the government, will be presented together with their effect on the use of antimicrobials.

Type
Reviews
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Malig, C. The civil registration system in Denmark. Bethesda, MD: International Institute for Vital Registration and Statistics; 1996;66:19.Google Scholar
2. World Health Organization. Anatomical Therapeutic Chemical (ATC) classification index—including defined daily doses (DDD) for plain substances. Oslo, Norway: WHO Collaborating Centre for Drug Statistics and Methodology; 1995.Google Scholar
3. Capellá, D. Descriptive tools and analysis. In: Dukes, MNG, ed. Drug Utilisation Studies. Methods and Uses. Copenhagen, Denmark: WHO Regional Office for Europe; 1993:5578. WHO Regional Publications, European series no. 45.Google Scholar
4. Bager, F, ed. DANMAP 98—Consumption of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Food and Humans in Denmark. Copenhagen, Denmark: Danish Zoonosis Centre; 1999. http://www.svs.dk/uk/Organization/z/Lgo_zoo.htm.Google Scholar
5. Justesen, T, Korsager, B, Scheibel, J. Vejledning i brug af antibiotika. In: Aldershvile, J, Hansen, MS, Kampmann, JP, Vej-Hansen, B, eds. Lœgeforeningens Medicinfortegnelse 1998. 21st ed. Copenhagen, Denmark: Lægeforeningens Forlag; 1998.Google Scholar
6. Kolmos, HJ, Little, P. Controversies in management: should general practitioners perform diagnostic tests on patients before prescribing antibiotics? BMJ 1999;318:799802.CrossRefGoogle ScholarPubMed
7. Segovia, J, Edwards, A, Bartlett, R. Newfoundland Panel on Health and Medical Care: Medical Care Utilization, 1992-5. St John's, Newfoundland, Canada: Memorial University of Newfoundland; 1997:88.Google Scholar
8. Friis, H, Bro, F, Mabeck, CE, Vejlsgaard, R. Changes in prescription of antibiotics in general practice in relation to different strategies for drug information. Dan Med Bull 1991;38:380382.Google ScholarPubMed
9. EPI NEWS, No. 46, 1998. ISSN 1396-4763. Statens Serum Institut, Copenhagen, Denmark, http://www.ssi.dk/en/index.html.Google Scholar