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National antibiotic stewardship programmes recommend monitoring antibiotic consumption and benchmarking. The WHO recommend the Anatomic Therapeutic Chemical classification and respective Defined Daily Doses (DDD) for drug utilization research. This is the most frequently used unit of measure within the European Union (EU). Wide variations in antibiotic consumption exist between EU countries in the outpatient setting, ranging in 2012 from 11.3 (the Netherlands) to 31.9 DDD per 1000 inhabitants and per day (Greece). Penicillins are the most consumed antibacterial agents in the community in all EU countries. Amoxicillin and amoxicillin/clavulanate are the two most widely prescribed penicillins, except in Denmark, Norway and Sweden where penicillin V and other very narrow-spectrum penicillins are used preferentially., peer-reviewed

Quality indicators for antimicrobial drug use should aim in improving the quality of their prescribing and reduce the cost Simply measuring something will not automatically improve it Indicators do not provide definitive answers but indicate potential problems that might need addressing Further develompment of QIs for antimicrobial prescribing as well as their validation is needed

Monitoring of antibiotic drug prescribing is of growing concern due to resistance, adverse reactions and cost. Thus, strict antibiotic policies are warranted. Prior to their implementation, detailed knowledge of antibiotic prescribing patterns is required. In this prospective, pilot study the utilization of antibiotics at the Pediatric Clinic, University Hospital Center Rijeka, Croatia has been analyzed. During a period from 8 January-15 February, 2003, patient charts were reviewed with regard to antibiotic prescription. Antibiotics were prescribed to 88 patients. In 72% of the patients antibiotics were given empirically, and only 20% had proven bacterial infection. More than one antibiotic was prescribed to 15%, and it was changed in 42% of the patients. In total, 150 antibiotic courses were prescribed. Restricted antimicrobials were given in 67% of the courses. Third generation cephalosporins were most commonly prescribed (48% of courses). Ceftriaxone was the single most prescribed drug (29%). Since it is not recommended to use a combination of drugs or a restricted antimicrobial as a first choice in empiric treatment, further diagnose-linked analysis is necessary. It also needs to be assessed whether the reason for such an extensive number of switches in antibiotic agents was a reflection of treatment failure.