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European surveillance of antimicrobial consumption
EC contribution
: € 880.606
: 36 months
Starting date
: 01/12/2004
Funding scheme
: Surveillance Project
: pharmacoepidemiology, antimicrobials, antibacterials, antimycotics
Contract/Grant agreement number
: 2003211
Project web-site


In 2001, the European Commission (Directorate-General SANCO - Health Monitoring Program) funded the European Surveillance of Antimicrobial Consumption (ESAC) project. A pilot project was established from 2001 to 2003 (referred to as ESAC-1). The aim of the project was to collect comparable and reliable data on antibiotic use in Europe in ambulatory and hospital care from publicly available sources, and to assess the time trends in human exposure to antibiotics. In this project a 'network of networks' approach was taken. A multidisciplinary management team based at the University of Antwerp, Belgium, established a network of dedicated national representatives (NR), collaborating on a voluntary basis. In each country, the national representative was to contact potential data providers. Data collection was aggregated at the level of the active substance (not at brand level), using the taxonomy of the Anatomical Therapeutic Chemical (ATC) classification system, as recommended by the World Health Organisation (WHO). The original data collection was limited to the ATC class J01. Consumption was expressed in defined daily doses (DDD).

In 2004, the European Commission (Directorate-General SANCO - Health Monitoring Program) decided to continue funding ESAC from 2004 to 2007 (referred to as ESAC-2). The main objective of the second phase of the ESAC project was to consolidate the continuous collection of comprehensive antibiotic consumption data. In addition, use data (i) on antibiotics not included in ATC class J01 (combinations for eradication of Helicobacter pylori, oral metronidazole, ornidazol, vancomycin, and colistin), (ii) at the package level, and (iii) of antimycotics for systemic use, were collected. In-depth consumption data for ambulatory care, hospital care, and nursing homes were investigated, and a pharmaco-economic evaluation was carried out. Finally, a set of twelve quality indicators for outpatient antibiotic use, which can be derived from ESAC data, were developed.

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