[Development of resistance and antibiotic consumption].

The development of antibiotics resistance is reaching epidemic proportions. Due to increased transportation of persons and goods across continents, some bacterial clones have disseminated over several countries. To increase benefits and reduce risk, and therefore improve quality of prescription, the rational use of antibiotics should be promoted. To do so, patterns of use and prescription rates expressed in DDD per 1,000 hospital beds should be examined. Hospitalised patients received 25-40% of all systemic doses, in many cases inappropriately. In community studies reference estimates are made per 1,000 inhabitants-day (DHD). Over the last years, consumption has levelled-of around 20 DHD in 2000, showing remarkable differences between regions in Spain. Antibiotic consumption is approximately 270 Tons (in 1997), with an increase of only 10% in the last decade. The URANO study estimated that 19% of patients receive chemotherapy, although 42% do not comply with treatment and 29% are self-medicated. Among the chemotherapeutic agents mostly used are penicillins (11.4 DHD), macrolides (3.6 DHD), Quinolones (2.2 DHD) and Cephalosporins (1.9 DHD). We recommend surveillance of antibiotics resistance and improvement in the training of health professionals and in health information for patients about risks of self-medication; we also propose a better control of antibiotics administered to farm animals.