Bindel Lilly Josephine, Seifert Roland
Hannover Medical School, Institute of Pharmacology, D-30625, Hannover, Germany.
Naunyn Schmiedebergs Arch Pharmacol. 2025 Jan 4. doi: 10.1007/s00210-024-03721-4.
The increasing supply shortages of antibacterial drugs presents significant challenges to public health in Germany. This study aims to predict the future consumption of the ten most prescribed antibacterial drugs in Germany up to 2040 using ARIMA (Auto Regressive Integrated Moving Average) models, based on historical prescription data. This analysis also evaluates the plausibility of the forecasts. Our findings represent one of the first long-term national forecasts for antibacterial drug consumption. ARIMA(0,1,0), a random walk model with drift, is the best-fitting model to capture trends across all antibacterial drugs. While more complex models offer greater detail, they seem less suitable for long-term forecasting. In a short-term forecast of 5 and 10 years, predictions between significant models vary very little. Predictions indicate increasing DDD-prescriptions for amoxicillin, cefuroxime axetil, amoxicillin clavulanic acid, clindamycin, azithromycin, nitrofurantoin, and ciprofloxacin, while declines are forecasted for doxycycline, phenoxymethylpenicillin, and sulfamethoxazole-trimethoprim. The reliability of the predictions varies. Forecasts for azithromycin, phenoxymethylpenicillin, and sulfamethoxazole-trimethoprim are likely accurate, whereas uncertainties exist for doxycycline, amoxicillin clavulanic acid, nitrofurantoin, and ciprofloxacin, though general trends appear valid. Potential discrepancies may arise in the predictions for amoxicillin, cefuroxime axetil, and clindamycin. These forecasts highlight the urgent need for proactive healthcare planning to prevent future shortages, a problem underscored by recent supply disruptions in Germany. Future research should extend this analysis to the development of bacterial resistance and other frequently used drug classes.
抗菌药物供应短缺情况日益严重,给德国的公共卫生带来了重大挑战。本研究旨在利用自回归积分滑动平均(ARIMA)模型,基于历史处方数据,预测到2040年德国处方量排名前十的抗菌药物的未来消费量。该分析还评估了预测的合理性。我们的研究结果是首批针对抗菌药物消费的长期全国性预测之一。ARIMA(0,1,0),即带漂移的随机游走模型,是最适合捕捉所有抗菌药物趋势的模型。虽然更复杂的模型能提供更多细节,但它们似乎不太适合长期预测。在5年和10年的短期预测中,重要模型之间的预测差异很小。预测表明,阿莫西林、头孢呋辛酯、阿莫西林克拉维酸、克林霉素、阿奇霉素、呋喃妥因和环丙沙星的限定日剂量(DDD)处方量将增加,而强力霉素、苯氧甲基青霉素和复方磺胺甲恶唑的处方量预计将下降。预测的可靠性各不相同。阿奇霉素、苯氧甲基青霉素和复方磺胺甲恶唑的预测可能较为准确,而强力霉素、阿莫西林克拉维酸、呋喃妥因和环丙沙星存在不确定性,不过总体趋势似乎是有效的。阿莫西林、头孢呋辛酯和克林霉素的预测可能会出现潜在差异。这些预测凸显了积极进行医疗保健规划以防止未来短缺的迫切需求,德国近期的供应中断也凸显了这一问题。未来的研究应将这一分析扩展到细菌耐药性的发展以及其他常用药物类别。