Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
J Antimicrob Chemother. 2010 Apr;65(4):769-74. doi: 10.1093/jac/dkq023. Epub 2010 Feb 8.
To assess the total outpatient systemic antimycotic and antifungal use in Europe, and to identify the antimycotic and antifungal substances most commonly used.
Within ESAC (www.esac.ua.ac.be), using the anatomical therapeutic chemical (ATC) and defined daily dose (DDD) classification, data on outpatient use of all 14 antimycotics (12) and antifungals (2) for systemic use (ATC J02 and D01B, respectively), aggregated at the level of the active substance, were collected for 2007. Use was expressed in DDD (WHO ATC/DDD, version 2008) per 1000 inhabitants per day (DID). Only countries for which data on both J02 and D01B use were available were included in the analysis.
In 20 European countries (data for Cyprus and Estonia include hospital use), total outpatient systemic antimycotic and antifungal use varied by a factor of 6.7 between the country with the highest (3.03 DID in Belgium) and the country with the lowest (0.45 in Croatia) use. Terbinafine, ketoconazole, itraconazole and fluconazole represented >94% of the total outpatient antimycotic and antifungal use in all countries. Terbinafine use represented >50% of the total systemic antimycotic and antifungal use in 16 out of 20 countries (not in Croatia, Italy, Luxembourg and Bulgaria).
We present for the first time a standardized and validated data set of outpatient systemic antimycotic and antifungal use in Europe. Our study demonstrates a variation of antimycotic and antifungal use in Europe, as striking as that of antibiotic use. The ESAC data facilitate the auditing of antimycotic and antifungal prescribing, and the evaluation of the implementation of guidelines and public health policies to promote their judicious use.
评估欧洲的门诊全身性抗真菌药物和抗真菌药物的总使用情况，并确定最常使用的抗真菌药物和抗真菌药物。
在 ESAC（www.esac.ua.ac.be）中，使用解剖治疗化学（ATC）和定义日剂量（DDD）分类，收集了 2007 年所有 14 种抗真菌药物（12 种）和 2 种用于系统性使用的抗真菌药物（ATC J02 和 D01B）的门诊使用数据，汇总到活性物质水平，以每 1000 人每天（DID）的 DDD（WHO ATC/DDD，版本 2008）表示。仅分析了既有 J02 又有 D01B 使用数据的国家。
在 20 个欧洲国家（塞浦路斯和爱沙尼亚的数据包括医院使用情况）中，总门诊全身性抗真菌药物和抗真菌药物的使用量在使用量最高的国家（比利时 3.03 DID）和使用量最低的国家（克罗地亚 0.45）之间相差 6.7 倍。特比萘芬、酮康唑、伊曲康唑和氟康唑占所有国家总门诊抗真菌药物和抗真菌药物使用量的>94%。特比萘芬在 20 个国家中的 16 个（克罗地亚、意大利、卢森堡和保加利亚除外）中占总系统性抗真菌药物和抗真菌药物使用量的>50%。
我们首次在欧洲提供了门诊全身性抗真菌药物和抗真菌药物使用情况的标准化和验证数据集。我们的研究表明，欧洲的抗真菌药物和抗真菌药物的使用存在差异，与抗生素的使用一样引人注目。ESAC 数据有助于对抗真菌药物和抗真菌药物处方进行审核，并评估指南的实施和公共卫生政策，以促进其合理使用。
