Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe.

BACKGROUND: There are no reliable data on antibiotic use in non-European Union (EU) southern and eastern European countries and newly independent states. We aimed to collect valid, representative, comparable data on systemic antimicrobial use in these non-EU countries of the WHO European region. METHODS: Validated 2011 total national wholesale antibiotic-use data of six southern and eastern European countries and regions and seven newly independent states were analysed in accordance with the WHO anatomical therapeutic chemical (ATC)/defined daily doses (DDD) method and expressed in DDD/1000 inhabitants per day (DID). FINDINGS: Total (outpatients and hospital care) antibiotic use ranged from 15·3 DID for Armenia to 42·3 DID for Turkey. Co-amoxiclav was mainly used in Georgia (42·9% of total antibiotic use) and Turkey (30·7%). Newly independent states used substantial quantities of ampicillin and amoxicillin (up to 55·9% of total antibiotic use in Azerbaijan). Montenegro and Serbia were the highest consumers of macrolides (15·8% and 19·5% of total antibiotic use, respectively), mainly azithromycin. Parenteral antibiotic treatment is common practice: 46·4% of total antibiotic use in Azerbaijan (mainly ampicillin; 5·3 DID) and 31·1% of total antibiotic use in Tajikistan (mainly ceftriaxone; 4·7 DID). INTERPRETATION: This study provides publicly available total antibiotic-use data for 13 non-EU countries and areas of the WHO European region. These data will raise awareness of inappropriate antibiotic use and stimulate policy makers to develop action plans. The established surveillance system provides a method to develop quality indicators of antibiotic use and to assess the effect of policy and regulatory actions. FUNDING: Netherlands Ministry of Health, Welfare, and Sport, and EU.

Availability and affordability of medicines and assessment of quality systems for prescription of medicines in the Republic of Moldova: final report

An overall assessment of the pharmaceutical sector in the Republic of Moldova wasperformed during 2011–2012, with the purpose of providing the Ministry of Healthwith comprehensive evidence regarding access to essential medicines of goodquality. This report presents the results, based on a secondary analysis of evidencecollected during a series of assessments conducted by the World Health OrganizationRegional Office for Europe in collaboration with the Ministry of Health of the Republicof Moldova, the Medicines Agency, Nicolae Testemitanu Republic of MoldovaState Medical and Pharmaceutical University, and Health Action International. Theassessments covered the areas of: public procurement; main regulatory functions;availability, affordability, prices and price components of essential medicines; andan evaluation of the essential list of medicines, prescribing practices and pricingpolicies. The main recommendations of the report provide insights into ways ofimproving regulatory and procurement practices, along with the best methods toconstrain the costs of medicines.