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[Consumption of antibiotics and their possible relationship with bacterial resistance in the "Costa de Ponent" health region: analysis of evolution through the initial and end periods of the last decade].

OBJECTIVE
To analyse antibiotic consumption (ABC) and its trend in primary care in an area with a high rate of bacterial resistance during the periods 1993-96 and 2000-02.


DESIGN
Comparative, retrospective analysis.


SETTING
Costa de Ponent Health Region. Population in 1993-96 period was 1,158,098 inhabitants; in 2000-02 period, 1,188,007 inhabitants.


PARTICIPANTS
Those patients in the Area who took AB during the periods under study.


MEASUREMENTS
Data obtained from the appropriate records of the Catalan Health Service. Measurement of ABC was the Defined Daily Dose (DDD)/1000 inhabitants/day (DID) [criteria of the WHO Collaborating Centre for Drugs Statistics Methodology]. Trends were quantified as percentage increase or drop, comparing the 1993-96 and 2000-02 periods. The U Mann-Whitney test was used.


RESULTS
Overall consumption was high, with a light fall from 17.049 DID during the first period to 15.826 DID in the second (-7.1%). Amoxycillin increased from 4.878 DID (57.6%) to 6.19 DID (67.6%) (+26.8%), but amoxycillin-clavulanic did not rise. The percentages of macrolides, quinolones, cephalosporins, sulphonamides, and tetracyclines were higher in the first period. The variations in the consumption of clarithromycin, azithromycin, cefuroxime, cefixime, and ciprofloxacin between the two periods was the most notable point.


CONCLUSIONS
Although overall ABC was high and in accord with the high rate of bacterial resistance in our area, a satisfactory evolutionary trend was found. The fall in consumption in the second period was not significant, but an appropriate modification in its profile was noted: domination of aminopenicillins and drop in macrolides, cephalosporins and fluorquinolones.