Table 1. Countries with established objectives and targets for the reduction of antibiotic use in humans, TATFAR survey, 2017 (n=9 countries).
| Country | Setting | Objective | Unit of measure | Target | Year by which the target must be reached | Comments |
|---|---|---|---|---|---|---|
| Belgium | Ambulatory care | Reduction in total antibiotic prescription rate | Prescriptions per 1,000 inhabitants and per year |
From > 800 in 2014 to 600 by 2020 and 400 by 2025 |
2020 and 2025 | None |
| Reduction in quinolone consumption | Proportion of total antibiotic consumption | From ca 10% in 2014 to 5% | 2018 | None | ||
| Increase in the yearly prescription ratio for amoxicillin/amoxicillin-clavulanic acid | Not applicable | From ca 50/50 in 2014 to 80/20 | 2018 | None | ||
| France | Alla | Reduce the total consumption of antibiotics for systemic use | DDD per 1,000 inhabitants per day | By 25% (cf.d with 2011) |
2016 | None |
| Ambulatory care | Reduction of antibiotic prescriptions for patients aged 16–65 years without chronic diseases | Number of prescriptions per 100 patients | ≤ 14 | December 2017 | Pay for performance target for GPs | |
| Reduce the proportion of patients treated yearly with ‘critical antibiotics’ (amoxicillin-clavulanic acid, third- and fourth-generation cephalosporins, fluoroquinolones) | Percentage of all antibiotic prescriptions | ≤ 27% | December 2017 | Pay for performance target for GPS | ||
| Reduction of the ratio of children treated with third- or fourth-generation cephalosporin (as percentage of children receiving antibiotics) | Not applicable | ˂ 3% of children < 4 years old; ˂ 2% of children ≥ 4 years old |
NA | Pay for performance target for paediatricians | ||
| Malta | Hospital care | Reduction of the use of carbapenems | DDD per 1,000 bed-days | By 50% (cf.d with 2016) |
2019 | None |
| Netherlands | All | Reduction of the proportion of inappropriately prescribed antibiotics, across the entire healthcare chain | NA | By ≥ 50% | 2019 | Baseline values are being determined |
| Norway | Ambulatory care | Reduction of total antibiotic consumption | DDD per 1,000 inhabitants per day | By 30% (cf.d with 2012) |
2020 | None |
| Reduction of average total antibiotic prescription rate | Prescriptions per 1,000 inhabitants per year | 250 | 2020 | None | ||
| Reduction of antibiotic prescriptions to treat respiratory infections | DDD per 1,000 inhabitants per day | By 20% (cf.d with 2012) |
2020 | None | ||
| Reduce the proportion of phenoxymethylpenicillin prescriptions for respiratory tract infections in children aged 0–6 years | Percentage of the total number of antibiotic prescriptions for this indication in children aged 0–6 years | ≥ 80% | NA | Target from the national treatment guidelines | ||
| Reduce the proportion of fluoroquinolones (and in particular of ciprofloxacin) prescriptions in uncomplicated urinary tract infections in women aged 20–79 years | Percentage of the total number of antibiotic prescriptions for this indication in women aged 20–79 years | ≤ 8% | NA | Target agreed by the National Antibiotics Committee | ||
| Reduction of prescription rate of antibiotics for respiratory tract infections in children aged 0–6 years | DDD per 1,000 inhabitants per day | By 30% | NA | Target agreed by the National Antibiotics Committee | ||
| Hospital care | Reduction of the use of broad-spectrum antibiotics | DDD per 100 beds per day | By 30% (cf.d with 2012) |
2020 | None | |
| Slovenia | Ambulatory care | Reduction of total antibiotic consumption | DDD per 1,000 inhabitants per day | By 20% (cf.d with 2017) |
2024 | None |
| Hospital care | Reduction of total antibiotic consumption | DDD per 1,000 inhabitants per day | By 10% (cf.d with 2017) |
2024 | None | |
| Sweden | Ambulatory care | Reduce total antibiotic prescription rate | Prescriptions per 1,000 inhabitants per year | ≤ 250 | NA | None |
| Increase proportion of phenoxymethylpenicillin commonly used to treat respiratory tract infections in children aged 0–6 years | Percentage of the total number of antibiotic prescriptions for this indication in children aged 0–6 years | ≥ 80% | NA | None | ||
| Decrease proportion of fluoroquinolones vs all antibiotics commonly used to treat urinary tract infections in women aged 18–79 years | Percentage of the total number of antibiotic prescriptions for this indication in women aged 18–79 years | ≤ 10% | NA | None | ||
| Increase of the proportion of first line treatment to treat urinary tract infections in women with afebrile urinary tract infection | Percentage of the total number of antibiotic prescriptions for this indication in women | > 80% | NA | Target suggested by the Strama Programme Council operational plan | ||
| Increase of the proportion of first line treatment to treat urinary tract infections in men with afebrile urinary tract infection | Percentage of the total number of antibiotic prescriptions for this indication in men | > 50% | NA | Target suggested by the Strama Programme Council operational plan | ||
| Increase of the proportion of patients treated against pharyngotonsilitis who receive penicillin V | Percentage of the total number of antibiotic prescriptions for pharyngotonsilitis | > 90% | NA | Target suggested by the Strama Programme Council operational plan | ||
| Decrease of the proportion of patients with acute bronchitis who receive antibiotic treatment | Percentage of the total number of patients with acute bronchitis | < 10% | NA | Target suggested by the Strama Programme Council operational plan | ||
| Hospital care | Increase proportion of patients with community-acquired pneumonia not requiring intensive care, initially treated with penicillin | Percentage of the total number of patients with community-acquired pneumonia not requiring intensive care | > 60% | NA | Target suggested by the Strama Programme Council operational plan | |
| Increase proportion of patients with afebrile urinary tract infection receiving first line treatment | Proportion of the total number of patients with afebrile urinary tract infection | > 90% | NA | Target suggested by the Strama Programme Council operational plan | ||
| UK | Ambulatory care (England) |
Reduction of inappropriate antibiotic prescribing for urinary tract infections | Trimethoprim/nitrofurantoin prescribing ratio and number of trimethoprim items prescribed to patients aged ≥ 70 years | At least a 10% reduction in both (cf.d with June 2015-May 2016) | NA | Pay for performance target (valid until 2018) |
| Reduce inappropriate prescribing in ambulatory care | Number of prescribed items per STAR-PU |
Equal to or below the 2013–14 baseline mean performance value for England of 1.161 items per STAR-PU | NA | Pay for performance target (valid until 2019) | ||
| Ambulatory care (Scotland) |
Reduction of inappropriate antibiotic prescribing | Number of items per 1,000 patients per day | Prescribing rate ≤ that of the Scottish 25th percentile or achieve an acceptable minimum reduction towards that level; the acceptable minimum level of reduction is defined as a reduction in the number of items per 1,000 patients per day equivalent to one fifth of the national IQR | NA | None | |
| Hospital care (England) |
Reduction in consumption of all antibiotics (total), carbapenems piperacillin-tazobactam | DDD per 1,000 admissions | By 1% (cf.d with 2013–14) for those trusts with 2016 consumption indicators below the 2013–14 median value or by 2% (cf.d with 2013–14) for those trusts with 2016 consumption indicators above the 2013–14 median value | NA | Pay for performance target (valid until 2018) | |
| Hospital care (Scotland) |
Reduction in consumption of all antibiotics (total), carbapenems, piperacillin-tazobactam | DDD per 1,000 admissions | By 1% (cf.d with January–December 2015). | NA | Proposed indicator | |
| US | Ambulatory care | Reduction of inappropriate use of antibiotics for monitored conditions | NA | By 50% (cf.d with 2010) |
2020 | None |
| Hospital care | Reduction of inappropriate use of antibiotics for monitored conditions | NA | By 20% (cf.d with 2011) |
2020 | None |
cf.d.: compared; DDD: defined daily dose; GPs: general practitioners; IQR: interquartile range; NA: not available; STAR-PU: specific therapeutic group age-sex related prescribing unit; TATFAR: Transatlantic Taskforce on Antimicrobial Resistance; UK: United Kingdom; US: United States.
a In all instances herein, ‘All’ refers to ambulatory and hospital care.