5 Antimicrobial consumption in humans
Read the full chapter about antimicrobial consumption for humans here
Report Highlights 2023:
Antimicrobial consumption in primary health care in Denmark
Antimicrobial consumption in Denmark was 16.54 DID in 2023, 6.3% lower than consumption in 2014 (17.64 DID) and 6.6% higher than in 2022 (15.51.44 DID) underlining that consumption has resurged since the COVID-19 related decreases in 2020 and 2021.
In primary health care, total antimicrobial consumption was 14.56 DID in 2023, 7.2% higher than the 13.59 DID in 2022 and 6.9% lower than in 2014 (15.64 DID). The increasewas driven by a 23% increase in beta-lactamase sensitive penicillins in primary health care. The four groups of penicillins constituted 67% of the consumption and beta-lactamase sensitive penicillins were the most used group of antimicrobials (accounting for 27% of total consumption in primary health care).
Antimicrobials prescribed for respiratory tract infections dropped sharply with the emergence of COVID-19 in 2020 due to the implemented societal restrictions. In 2022 and 2023, the usual winter peak in antimicrobial consumption reached a higher level than observed for 2018-2019. This was due to high rates of viral infections, in particular an early and more severe RSV and influenza season, and an outbreak of Group A streptococci.
Antimicrobials prescribed to children demonstrated marked increases in the recent two years. Among the 0-4 year olds, consumption in 2023 was 298 treated patients per 1,000 inhabitants, a 30% increase compared to 229 treated patients per 1,000 inhabitants in 2022. For the 5-9 year olds, 197 patients per 1,000 inhabitants were treated in 2023 compared to 122 patients per 1,000 inhabitants in 2022 (60% increase).
Elderly inhabitants living at care homes during 2023 received 90% more antimicrobials than elderly inhabitants living in their own homes (1,819 prescriptions per 1,000 inhabitants at long term care facilities compared to 957 prescriptions per 1,000 inhabitants in their own homes). Urinary tract infections were the main cause of the observed difference in the treatment frequency. However, consumption for elderly inhabitants living at care homes has decreased by 28% from 2017 to 2023, while consumption for elderly living in their own homes has decreased by 16%.
Antimicrobial consumption in hospital care measured in DID (i.e. not accounting for hospital activity) was 1.91 DID in 2023, 3% higher than in 2022 (1.86 DID). When measuring in DDD per 100 bed-days (DBD), the consumption in 2023 (135.6 DBD) was 5.6% higher than in 2022 (128.42 DBD) and 36% higher than in 2014 (99.44 DBD).
Product shortages are of increasing concern in antimicrobial supply. In 2023, nitrofurantoin was unavailable in several months due to product shortage. Simultaneously, the supply through special deliveries increased. Also other antimicrobials for urinary tract infection treatment increased at the same time.
AWaRe classification of antimicrobials used in Denmark showed that 84% consisted of access antimicrobials (WHO’s goal is 60% access antimicrobials).