The characteristics and trends of Hungarian outpatient antibiotic use(2010-2019)

Introduction: Prudent antibiotic use is an important tool to preserve their effectiveness as well as reverse and confine antibiotic resistance. Objective: To evaluate the trends and characteristics of Hungarian outpatient antibiotic use. Methods: Crude, package level antibiotic sales data for the period 2010-2019 were converted into DDD (defined daily dose) and were standardized for 1000 inhabitants and per year (ATC-DDD index, version 2019). Internation- ally validated drug -specific quality indicators were used to evaluate antibiotic use. Results: The scale of antibiotic use was stagnating with minimal fluctuation (min.: 12.9 DID, max.: 14.7 DID), and with high intra-year seasonality index. The ratio of the consumption of broad to narrow spectrum beta-lactams and macrolides increased gradually from year to year (2010: 13.3 vs. 2019: 71.6) and the relative consumption of fluoro- quinolones is still remarkable (2010: 14.3%, 2019: 14.5%). Out of the twelve surveyed drug -specific quality indica- tors in the first and last year of analysis, we were ranked among the weakest European countries in the case of four and six indicators, respectively. Discussion: The scale of Hungarian outpatient antibiotic use is not high, in European comperison, but has some re- serve capacity for reduction. The pattern of Hungarian antibiotic use is suboptimal and had further decreased qual- ity through the years. Conclusion: Based on the recorded data of antibiotic use and their interpretation, the development of national anti- biotic strategy (including both professional and authority interventions) is a pressing moral obligation.