Non-hospital consumption of antibiotics in Spain: 1987-1997.

Spain has one of the highest incidences of bacterial resistance to antimicrobials, possibly linked to drug consumption patterns. Using Ministry of Health and Consumer Affairs records, data were obtained on non-hospital sales of antibiotics for the period 1987-1997, and equivalents calculated in weight of active drug ingredient and defined daily doses per 1000 population per day (DDD/1000/day). The number of packages sold declined from 75 million in 1987 to 55 million in 1997. None the less, there was a gradual yet steady rise in consumption in tonnage terms (249 to 275 tonnes). Furthermore, in terms of DDD/1000/day, consumption rose sharply until 1995 and then held steady at 21 DDD/1000/day, a level comparable to the mean for other developed countries. Penicillins were the group to register the highest consumption in Spain, followed-in the latter years of the study-by macrolides, cephalosporins and quinolones. The marked rise in these latter three groups was noteworthy. Despite the decrease in the number of packages sold, antibiotic consumption in Spain has risen. This consumption pattern is different from that of other European countries and might serve to explain differences in the generation of resistance.