Per capita antibiotic consumption: how does a North American jurisdiction compare with Europe?

Antibiotic consumption in populations affects the emergence of resistant organisms. We compared 1996-2000 trends in consumption in British Columbia, Canada, with those in Europe. Prescription data from the British Columbia PharmaNet database were converted into SAS files and classified using the Anatomical Therapeutic Chemical system, and weights of antibiotics were converted into defined daily doses (DDDs) using the 2001 definitions from the World Health Organization Collaborating Center for Drug Statistics Methodology. During 1996-2000, consumption in British Columbia decreased from 19.5 to 17.9 DDDs/1000 inhabitant-days. Although antibiotic consumption in British Columbia was less than the European median in 2000, it exceeded that in northern European countries with established antibiotic surveillance and control programs. The consumption rates for fluoroquinolones, newer macrolides, and cephalosporins in British Columbia exceeded those in Denmark (1.44 vs. 0.15, 1.59 vs. 0.92, and 1.86 vs. 0.02 DDDs/1000 inhabitant-days, respectively). The observed increase in and pattern of consumption associated with newer antimicrobials may increase the risk for emergence of antimicrobial-resistant organisms in British Columbia.