Surveillance of Antimicrobial Use
Surveillance of antimicrobial use tracks how and why antimicrobials are being used and misused by patients and healthcare providers. Monitoring antimicrobial prescription and consumption behavior provides insights and tools needed to inform therapy decisions, to assess the public health consequences of antimicrobial misuse, and to evaluate the impact resistance containment interventions.
As an advocacy resource at local or national level, the European Surveillance of Antimicrobial Consumption programme (ESAC) has demonstrated that monitoring antimicrobial use patterns and costs can prove the crucial factor driving political commitment to successful campaigns to contain resistance, especially when surveillance of use is enhanced by surveillance of resistance.
Tracking antimicrobial consumption and use behavior
Tracking consumption statistics quantifies the selection pressure on microbial populations and permits benchmarking comparisons at country or healthcare facility level and evaluation of the impact of educational or regulatory interventions. A common way to express consumption totals is through the use of “Defined-Daily Doses” or DDDs, maintained by the WHO Collaborating Centre for Drug Statistics Methodology in Oslo.
- Utilization: Drug use methodology
- WHO Collaborating Centre for Drug Statistics Methodology
- ABC Calc software
For insights into how antimicrobials are used, indicator studies and focused surveys of patients, prescribers, and dispensers are used to explore the factors which drive antimicrobial use decisions. Examples of indicators include the following.
- Average number of medicines prescribed per patient counter
- Percentage of encounters with an antibiotic prescribed
- Percentage of cases of malaria treated with recommended antibiotics
- Percentage of cases of diarrhoea treated with oral rehydration therapy
- Percentage of patients receiving medicines without prescription
WHO Guidelines for Surveillance of Antimicrobial Use
Health Clinics and Hospitals
- WHO Operational Package for Assessing, Monitoring, and Evaluating Country Pharmaceutical Situations (1.18M) (2007)
- First Meeting of the WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR). Copenhagen, 15-19 June 2009
Surveillance of antimicrobial use - reports
- Community-Based Surveillance of Antimicrobial Use and Resistance in Resource-Constrained Settings : Report on Five Pilot Projects (1.40M) (2009)
- Medicines Use in Primary Care in Developing and Transitional Countries: Fact Book Summarizing Results from Studies Reported Between 1990 and 2006 (3.46M) (2009)
- WHO's Database on Rational Use of Medicines (in Essential Drugs Monitor, Issue No. 33, 2003, p12) (1M) (2003)
- Using Indicators to Measure Country Pharmaceutical Situations: Fact Book on WHO Level I and Level II Monitoring Indicators (1M) (2006)