A study published today on antimicrobial resistance and the causes of non-prudent use of antibiotics carried out by Nivel (NL) as part of the EU-funded project ARNA, estimates that 7% of antibiotics taken in the EU are taken without a prescription. The highest rates of non-prescription use of antibiotics are in Romania (20%) and Greece (16%) with high rates also found in Cyprus, Hungary, Italy, Romania and Spain. Over the counter selling of antibiotics in pharmacies and the use of leftover antibiotics were found to be the main causes.

Reasons for such imprudent use of antibiotics include lack of knowledge by the patient, lack of knowledge by pharmacists, pharmacists consenting to sell antibiotics without a prescription - particularly when there is patient pressure, and healthcare providers dispensing whole packages of antibiotics where there are pills left over once a patient has finished the prescribed course. It was also found that pharmacists in smaller pharmacies seem more likely to dispense antibiotics without a prescription.

The report also describes follow-up dialogues which were held with Romania, Greece  Cyprus, Hungary, Italy, Romania and Spain  to discuss the results and help with preparing national action plans.

The study gives a number of policy recommendations, for example:

• A multi-faceted approach with interventions and policies that target both patients and healthcare professionals
• Education and awareness raising, e.g. media campaigns for citizens staring with school children, and education programmes for health professionals
• Better enforcement of laws in EU countries where antibiotics are available over the counter without prescription.

More information

• Read the study in full
• EU action on AMR
• Project ARNA - Antimicrobial Resistance and the causes of Non-prudent use of Antibiotics (ARNA) project