Antibiotic prescribing

Prescribing of medication is the most common form of treatment. However, inappropriate prescription and overuse of antibiotics results in antibiotic resistance which may in turn limit our ability to control basic infections. While we cannot establish the exact prescribing rate, trends should be closely monitored.

How does antibiotic prescribing compare internationally?

The OECD collects data on prescribing in different countries using a system of average Defined Daily Doses (DDDs) to account for the volume of drugs. Between 2000 and 2014, the volume of antibiotics prescribed in the UK increased from 14.3 DDDs per 1,000 inhabitants per day to 19.7 DDDs per 1,000 inhabitants per day. Since then, the volume has decreased reaching 18.7 DDDs per 1,000 inhabitants per day in 2016. The UK prescribes fewer antibiotics than the average of the comparator countries, and the recent decrease in volume prescribed is promising. Antibiotic prescribing is high in Greece, France and Belgium, and is low in the Netherlands, Austria and Sweden.

Updated July 2018.

How does prescribing of second-line antibiotics compare internationally?

Quinolones and cephalosporins are considered second-line antibiotics in most prescribing guidelines. They should be restricted for situations where first-line antibiotics have failed. It is important that they are used sparingly, to avoid drug-resistant bacteria developing. In the UK, the percentage of antibiotics prescribed that were quinolones or cephalosporins decreased from 8.6% in 2007 to 3.8% in 2012, and has since remained broadly stable reaching 3.5% in 2016. The UK performs the second best out of the comparator countries, with only Denmark having a lower proportion of second-line antibiotics.

Variation may be explained, on the supply side, by differences in regulation, guidelines and incentives that govern primary care prescribers and, on the demand side, by cultural differences in attitudes and expectations regarding the optimal treatment of infective illness. Further to this, there are some differences in definitions and comparability between countries. See the data notes below for more information.

Updated July 2018.

About this data

Definitions and comparability for the indicators are taken directly from the OECD report Health at a Glance 2017: OECD indicators. Detailed information about the definitions and the source and methods for each country can be found here.

Defined daily dose (DDD) is the assumed average maintenance dose per day for a drug used for its main indication in adults. DDDs are assigned to each active ingredient(s) in a given therapeutic class by international expert consensus. DDDs do not necessarily reflect the average daily dose actually used in a given country.

Data for Spain, United Kingdom, Portugal and Sweden include data for primary care physicians only. Data for Canada, Ireland and New Zealand include only those dispensed by community pharmacies. Data for Finland and Italy include outpatients only. Data for Australia include prescriptions dispensed at community pharmacies, private hospital pharmacies and public hospital outpatients and admitted day patients. Results for Canada only include data from the provinces of British Columbia, Manitoba and Saskatchewan.

Denominators comprise the population held in the national prescribing database, rather than the general population.

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