{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:10:59Z","timestamp":1791245459765,"version":"4.1.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T00:00:00Z","timestamp":1744416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Naunyn-Schmiedeberg's Arch Pharmacol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial resistance is a major threat to public health, with a well-established link between antibacterial consumption and bacterial resistance. Stewardship needs to focus on reducing overall consumption and optimising the quality of prescribing. The European Union\u2019s\u00a0\u2018One Health\u2019\u00a0approach aims for at least 65% of antibacterial consumption to be in the\u00a0\u2018Access\u2019\u00a0category of the AWaRe framework until 2030.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study advances the field by shifting the focus from simply quantifying antibacterial consumption to a nuanced assessment of prescribing quality. Prudent and problematic prescribing behaviour is identified in past and projected trends, both for individual countries and European regions. Progress towards the EU\u2019s \u2018One Health\u2019 targets for the human sector is assessed and compared with total antibacterial consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyses data from 1997\u20132023 and predicts future proportions of AWaRe drug classes for European countries until 2030, using the ARIMA(1,0,1) model. The distribution and changes of the AWaRe groups were analysed to assess prescribing behaviour. Total antibacterial consumption is compared with findings of the \u2018One Health\u2019 targets, and bivariate correlation analyses are performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Robust forecast models were developed for the AWaRe classification for 30 European countries. In 2030, the \u2018Access\u2019\u00a0group is projected to exceed 65% in Iceland, Denmark, Ireland, Latvia, Finland, France, the Netherlands, Sweden, Lithuania, the United Kingdom, Belgium and Estonia. On the other hand, low shares are expected for Greece (43.8%), Slovakia and Bulgaria (45.9%), Italy (47.3%), Malta (49.9%), Cyprus (50.9%), Hungary (51.8%) and Romania (53.4%). The other 10 countries fall in between, with shares ranging from 56.4% to 64.7%. Of particular concern are Italy, Cyprus and Malta, with low'Access'shares, high consumptions and worsening trends, in contrast to the exemplary performance of Iceland, Norway and Denmark. Germany stands out for its worryingly excessive use of \u2018Reserve\u2019. Most forecasts were considered reliable, although some showed moderate or poor fit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings predict that many European countries are unlikely to meet the EU's \u2018One Health\u2019 target by 2030. Countries with higher'Access'shares and lower total consumption tend to have lower levels of bacterial resistance, while those with high consumption and problematic prescribing patterns face higher levels of resistance. While most Northern European countries are considered to have a prudent use of medicines, problematic use is observed particularly in Southern and Eastern Europe, a practice being apparent across many medicine classes. Regional differences in prescribing patterns highlight the need for tailored interventions. For certain countries, particularly in Northern Europe, the high proportion of unclassified substances suggests that the AWaRe classification may not fully capture the range of antibacterial substances used.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00210-025-04121-y","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T03:04:49Z","timestamp":1744427089000},"page":"13707-13729","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["AWaRe classification analysis for European countries with ARIMA forecasts to assess prescribing patterns and \u2018One Health\u2019 targets"],"prefix":"10.1007","volume":"398","author":[{"given":"Lilly Josephine","family":"Bindel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,12]]},"reference":[{"key":"4121_CR1","doi-asserted-by":"publisher","unstructured":"Abejew AA, Wubetu GY, Fenta TG (2024) Relationship between antibiotic consumption and resistance: a systematic review. Can J Infect Dis Med Microbiol 2024:9958678. https:\/\/doi.org\/10.1155\/2024\/9958678","DOI":"10.1155\/2024\/9958678"},{"issue":"1","key":"4121_CR2","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/S1473-3099(20)30854-9","volume":"21","author":"I Adekoya","year":"2021","unstructured":"Adekoya I, Maraj D, Steiner L, Yaphe H, Moja L, Magrini N, Cooke G, Loeb M, Persaud N (2021) Comparison of antibiotics included in national essential medicines lists of 138 countries using the WHO Access, Watch, Reserve (AWaRe) classification: a cross-sectional study. Lancet Infect Dis 21(1):142\u2013150. https:\/\/doi.org\/10.1016\/S1473-3099(20)30854-9","journal-title":"Lancet Infect Dis"},{"key":"4121_CR3","doi-asserted-by":"publisher","unstructured":"Benk\u0151, R., Matuz, M., Pet\u0151, Z., Weist, K., Heuer, O., Vlahovi\u0107-Pal\u010devski, V., Monnet, D. L., Galistiani, G. F., Blix, H. S., So\u00f3s, G., Hajd\u00fa, E., Members of the ESAC-Net AWaRe study group, & ESAC-Net AWaRe study group (2022). Trends in the hospital-sector consumption of the WHO AWaRe Reserve group antibiotics in EU\/EEA countries and the United Kingdom, 2010 to 2018. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 27(41), 2101058. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.41.2101058","DOI":"10.2807\/1560-7917.ES.2022.27.41.2101058"},{"key":"4121_CR4","doi-asserted-by":"crossref","unstructured":"Bindel, L.J., Seifert, R. (2025b). Most European countries will miss EU targets on antibacterial use by 2030: historical analysis of European and OECD countries, comparison of community and hospital sectors and forecast to 2040. Naunyn-Schmiedeberg's Arch Pharmacol.","DOI":"10.1007\/s00210-025-03887-5"},{"key":"4121_CR5","doi-asserted-by":"crossref","unstructured":"Bindel, L.J., Seifert, R. (2025c). Long-term forecasting and evaluation of medicine consumption for the ATC class H with a focus on thyroid hormones in OECD countries using ARIMA models. Naunyn-Schmiedeberg's Arch Pharmacol.","DOI":"10.1007\/s00210-025-03930-5"},{"key":"4121_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-024-03171-y","author":"LJ Bindel","year":"2024","unstructured":"Bindel LJ, Seifert R (2024a) Costs are a major driver of antibacterial medicine prescriptions in Germany: market analysis from 1985 to 2022. Naunyn-Schmiedeberg\u2019s Arch Pharmacol. https:\/\/doi.org\/10.1007\/s00210-024-03171-y","journal-title":"Naunyn-Schmiedeberg's Arch Pharmacol"},{"key":"4121_CR7","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-024-03288-0","author":"LJ Bindel","year":"2024","unstructured":"Bindel LJ, Seifert R (2024b) DDD-costs have a strong influence on antibacterial medicine prescription in Germany: a differentiated correlation analysis from 1985 to 2022. Naunyn-Schmiedeberg\u2019s Arch Pharmacol. https:\/\/doi.org\/10.1007\/s00210-024-03288-0","journal-title":"Naunyn-Schmiedeberg's Arch Pharmacol"},{"key":"4121_CR8","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-024-03435-7","author":"LJ Bindel","year":"2024","unstructured":"Bindel LJ, Seifert R (2024c) Daily defined dose-costs have a stronger influence on antibacterial medicine prescriptions in Germany than bacterial resistance: economic factors are more important than scientific evidence. Naunyn-Schmiedeberg\u2019s Arch Pharmacol. https:\/\/doi.org\/10.1007\/s00210-024-03435-7","journal-title":"Naunyn-Schmiedeberg's Arch Pharmacol"},{"key":"4121_CR9","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-024-03533-6","author":"LJ Bindel","year":"2024","unstructured":"Bindel LJ, Seifert R (2024d) Development of bacterial resistance in Germany from 2008 to 2022 \u2013 major culprit pathogens, antibacterial medicines and prescribing practices. Naunyn-Schmiedeberg\u2019s Arch Pharmacol. https:\/\/doi.org\/10.1007\/s00210-024-03533-6","journal-title":"Naunyn-Schmiedeberg's Arch Pharmacol"},{"key":"4121_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-024-03721-4","author":"LJ Bindel","year":"2025","unstructured":"Bindel LJ, Seifert R (2025a) Long-term forecast for antibacterial drug consumption in Germany using ARIMA models. Naunyn-Schmiedeberg\u2019s Arch Pharmacol. https:\/\/doi.org\/10.1007\/s00210-024-03721-4","journal-title":"Naunyn-Schmiedeberg's Arch Pharmacol"},{"key":"4121_CR11","doi-asserted-by":"publisher","first-page":"442","DOI":"10.3389\/fphar.2018.00442","volume":"9","author":"L Bojani\u0107","year":"2018","unstructured":"Bojani\u0107 L, Markovi\u0107-Pekovi\u0107 V, \u0160krbi\u0107 R, Stojakovi\u0107 N, \u00d0ermanovi\u0107 M, Bojani\u0107 J, F\u00fcrst J, Kurdi AB, Godman B (2018) Recent Initiatives in the Republic of Srpska to Enhance Appropriate Use of Antibiotics in Ambulatory Care; Their Influence and Implications. Front Pharmacol 9:442. https:\/\/doi.org\/10.3389\/fphar.2018.00442","journal-title":"Front Pharmacol"},{"key":"4121_CR12","unstructured":"Box, G. E. P., Jenkins, G. M., Reinsel, G. C., & Ljung, G. M. (2015). Time Series Analysis: Forecasting and Control (5th ed.). Wiley."},{"key":"4121_CR13","unstructured":"Centers for Disease Control and Prevention (CDC). (2025). COVID-19 impacts on antimicrobial resistance. Last updated: February 5 2025. Last accessed: March 18 2025. https:\/\/www.cdc.gov\/antimicrobial-resistance\/data-research\/threats\/covid-19.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/drugresistance\/covid19.html"},{"key":"4121_CR14","doi-asserted-by":"publisher","unstructured":"Dance, A. (2024). Five ways science is tackling the antibiotic resistance crisis. News feature. Nature 632, 494\u2013496 (2024). https:\/\/doi.org\/10.1038\/d41586-024-02601-4","DOI":"10.1038\/d41586-024-02601-4"},{"issue":"366","key":"4121_CR15","doi-asserted-by":"publisher","first-page":"427","DOI":"10.2307\/2286348","volume":"74","author":"DA Dickey","year":"1979","unstructured":"Dickey DA, Fuller WA (1979) Distribution of the Estimators for Autoregressive Time Series With a Unit Root. J Am Stat Assoc 74(366):427\u2013431. https:\/\/doi.org\/10.2307\/2286348","journal-title":"J Am Stat Assoc"},{"issue":"12","key":"4121_CR16","doi-asserted-by":"publisher","first-page":"3063","DOI":"10.1093\/jac\/dkae370","volume":"79","author":"E Funiciello","year":"2024","unstructured":"Funiciello E, Lorenzetti G, Cook A, Goelen J, Moore CE, Campbell SM, Godman B, Tong D, Huttner B, Chuki P, Sharland M (2024) Identifying AWaRe indicators for appropriate antibiotic use: a narrative review. J Antimicrob Chemother 79(12):3063\u20133077. https:\/\/doi.org\/10.1093\/jac\/dkae370","journal-title":"J Antimicrob Chemother"},{"key":"4121_CR17","doi-asserted-by":"publisher","unstructured":"European Antimicrobial Resistance Collaborators (2022) The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis. Lancet Public Health 7(11):e897\u2013e913. https:\/\/doi.org\/10.1016\/S2468-2667(22)00225-0","DOI":"10.1016\/S2468-2667(22)00225-0"},{"key":"4121_CR18","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2024a) Antimicrobial consumption in the EU\/EEA (ESAC-net). Annual Epidemiological Report 2023. Surveillance report. Stockholm. Last updated: November 2024. Last Accessed: December 28 2024.https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/antimicrobial-consumption-ESAC-Net-annual-epidemiological-report-2023_0.pdf"},{"key":"4121_CR19","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2024b) Antimicrobial resistance in the EU\/EEA (ESAC-net). Annual Epidemiological Report 2023. Surveillance report. Stockholm. Last updated: November 2024. Last Accessed: December 28 2024.https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/antimicrobial-resistance-annual-epidemiological-report-EARS-Net-2023.pdf"},{"key":"4121_CR20","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2024c) Reducing antimicrobial resistance: accelerated efforts are needed to meet the EU targets. Last updated: November 18 2024. Last accessed: March 19 2025. https:\/\/www.ecdc.europa.eu\/en\/news-events\/reducing-antimicrobial-resistance-accelerated-efforts-are-needed-meet-eu-targets"},{"key":"4121_CR21","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2023) Antimicrobial stewardship. Prudent use of antibiotics. Directory: guidance on prevention and control. Last updated: February 14 2023. Last accessed: March 21 2025. https:\/\/www.ecdc.europa.eu\/en\/publications-data\/directory-guidance-prevention-and-control\/prudent-use-antibiotics\/antimicrobial"},{"key":"4121_CR22","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2025) Antimicrobial consumption dashboard. ESAC-net. Last Accessed: January 22 2025. https:\/\/qap.ecdc.europa.eu\/public\/extensions\/AMC2_Dashboard\/AMC2_Dashboard.html#eu-consumption-tab"},{"key":"4121_CR23","unstructured":"European Surveillance of Antimicrobial Consumption Network (ESAC-net) (2025) Antimicrobial consumption dashboard. European Centre for Disease Prevention and Control. Last updated: 2024. Last Accessed: March 20 2025. https:\/\/qap.ecdc.europa.eu\/public\/extensions\/AMC2_Dashboard\/AMC2_Dashboard.html#eu-consumption-tab"},{"key":"4121_CR24","unstructured":"European Union (2023) Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach 2023\/C 220\/01. Official Journal of the European Union. Document\u00a032023H0622(01). Last updated: June 16 2023. Last Accessed: March 15 2025. https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/?uri=celex%3A32023H0622%2801%29"},{"issue":"2","key":"4121_CR25","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1586\/14787210.2015.990381","volume":"13","author":"J F\u00fcrst","year":"2015","unstructured":"F\u00fcrst J, \u010ci\u017eman M, Mrak J, Kos D, Campbell S, Coenen S, Gustafsson LL, F\u00fcrst L, Godman B (2015) The influence of a sustained multifaceted approach to improve antibiotic prescribing in Slovenia during the past decade: findings and implications. Expert Rev Anti Infect Ther 13(2):279\u2013289. https:\/\/doi.org\/10.1586\/14787210.2015.990381","journal-title":"Expert Rev Anti Infect Ther"},{"key":"4121_CR26","unstructured":"Geddes L (2024) The devastating impact of war on antimicrobial resistance. VaccinesWork. Last updated: September 19 2024. Last accessed: March 18 2025. https:\/\/www.gavi.org\/vaccineswork\/devastating-impact-war-antimicrobial-resistance#:~:text=an%20alarming%20rate.-,%E2%80%9CIn%20the%20chaos%20of%20war%2C%20where%20medical%20professionals%20face%20overwhelming,of%20contributing%20to%20antimicrobial%20resistance.%E2%80%9D"},{"key":"4121_CR27","doi-asserted-by":"publisher","unstructured":"Gutema, G., H\u00e5konsen, H., Engidawork, E., Toverud, E.-L. (2021). Antibiotic stewardship in Norway: are strategies for rational use of antibiotics followed in Norwegian healthcare system? medRxiv 2021.02.01.21250947. https:\/\/doi.org\/10.1101\/2021.02.01.21250947.","DOI":"10.1101\/2021.02.01.21250947"},{"issue":"3","key":"4121_CR28","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1111\/1468-0009.12405","volume":"97","author":"B Hobaek","year":"2019","unstructured":"Hobaek B, Lie AK (2019) Less Is More: Norwegian Drug Regulation, Antibiotic Policy, and the \u201cNeed Clause.\u201d Milbank Q 97(3):762\u2013795. https:\/\/doi.org\/10.1111\/1468-0009.12405","journal-title":"Milbank Q"},{"key":"4121_CR29","unstructured":"Hyndman, R.J., Athanasopoulos, G. (2021) Forecasting: principles and practice. 2nd edition. OTexts: Melbourne, Australia. OTexts.com\/fpp2. Last Accessed: September 24 2024."},{"key":"4121_CR30","unstructured":"Island.is (2024). Increasing Antimicrobial Resistance and Antibiotic Use in Europe. Directorate of Health. News & Announcements. Last updated: November 22 2024. Last \u2018Access\u2019ed: January 27 2025. https:\/\/island.is\/en\/news\/vaxandi-syklalyfjaonaemi-og-syklalyfjanotkun-i-evropu"},{"key":"4121_CR31","doi-asserted-by":"publisher","unstructured":"Karakonstantis, S., Kalemaki, D. (2019). Antimicrobial overuse and misuse in the community in Greece and link to antimicrobial resistance using methicillin-resistant S. aureus as an example. Journal of Infection and Public Health. Volume 12, Issue 4, Pages 460\u2013464. ISSN 1876\u20130341. https:\/\/doi.org\/10.1016\/j.jiph.2019.03.017.","DOI":"10.1016\/j.jiph.2019.03.017"},{"issue":"1","key":"4121_CR32","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/S1473-3099(20)30332-7","volume":"21","author":"EY Klein","year":"2021","unstructured":"Klein EY, Milkowska-Shibata M, Tseng KK, Sharland M, Gandra S, Pulcini C, Laxminarayan R (2021) Assessment of WHO antibiotic consumption and access targets in 76 countries, 2000\u201315: an analysis of pharmaceutical sales data. Lancet Infect Dis 21(1):107\u2013115. https:\/\/doi.org\/10.1016\/S1473-3099(20)30332-7","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"4121_CR33","doi-asserted-by":"publisher","first-page":"4274","DOI":"10.3390\/ijerph10094274","volume":"10","author":"CR Lee","year":"2013","unstructured":"Lee CR, Cho IH, Jeong BC, Lee SH (2013) Strategies to minimize antibiotic resistance. Int J Environ Res Public Health 10(9):4274\u20134305. https:\/\/doi.org\/10.3390\/ijerph10094274","journal-title":"Int J Environ Res Public Health"},{"key":"#cr-split#-4121_CR34.1","unstructured":"MacBride-Stewart, S. et al. (2021). Initiatives and reforms across Scotland in recent years to improve prescribing"},{"key":"#cr-split#-4121_CR34.2","unstructured":"findings and global implications of drug prescriptions. Int J Clin Exp Med. 2021;14 (12):2563-86. ISSN:1940-5901\/IJCEM0139266"},{"key":"4121_CR35","doi-asserted-by":"crossref","unstructured":"McKinney, W. (2010). Data structures for statistical computing in Python. Proceedings of the 9th Python in Science Conference, 51\u201356. Last Accessed: January 30 2025. https:\/\/pub.curvenote.com\/01908378-3686-7168-a380-d82bbf21c799\/public\/mckinney-57fc0d4e8a08cd7f26a4b8bf468a71f4.pdf","DOI":"10.25080\/Majora-92bf1922-00a"},{"key":"4121_CR36","unstructured":"Ministry of Health Denmark (2017). NATIONAL ACTION PLAN ON ANTIBIOTICS IN HUMAN HEALTHCARE. Three measurable goals for a reduction of antibiotic consumption towards 2020. Last updated: July 2017. Last Accessed: January 27 2025. https:\/\/www.ism.dk\/Media\/6\/2\/National-handlingsplan-for-antibiotika-til-mennesker-UK%20version.pdf"},{"key":"4121_CR37","unstructured":"Ministry of Health Iceland (2024). National Action Plan (NAP) on Antimicrobial Resistance. ISBN: 978\u20139935\u2013515\u201348\u20133. Last updated: July 2024. Last Accessed: January 27 2025. https:\/\/www.stjornarradid.is\/library\/04-Raduneytin\/Heilbrigdisraduneytid\/ymsar-skrar\/A%C3%B0ger%C3%B0a%C3%A1%C3%A6tlun%20gegn%20s%C3%BDklalyfja%C3%B3n%C3%A6mi%20EN.pdf"},{"issue":"3","key":"4121_CR38","first-page":"69","volume":"24","author":"MM Mukaka","year":"2012","unstructured":"Mukaka MM (2012) Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Medical Journal: the Journal of Medical Association of Malawi 24(3):69\u201371 (PMID: 23638278)","journal-title":"Malawi Medical Journal: the Journal of Medical Association of Malawi"},{"key":"4121_CR39","doi-asserted-by":"publisher","unstructured":"Nandi, A., Pecetta, S., Bloom, D.E. (2023). Global antibiotic use during the COVID-19 pandemic: analysis of pharmaceutical sales data from 71 countries, 2020\u20132022. eClinicalMedicine, Volume 57, 101848, 2023;57: 101848. https:\/\/doi.org\/10.1016\/j.eclinm.2023.101848","DOI":"10.1016\/j.eclinm.2023.101848"},{"key":"4121_CR40","unstructured":"National Institute of Standards and Technology (NIST\/SEMATECH). (2012). E-Handbook of Statistical Methods. https:\/\/www.itl.nist.gov\/div898\/handbook\/. Last \u2018Accessed: October 4 2024."},{"key":"4121_CR41","doi-asserted-by":"publisher","unstructured":"Nature. (2024). A new class of antibiotics is cause for cautious celebration \u2014 but the economics must be fixed. Editorial. Nature 625, 7. https:\/\/doi.org\/10.1038\/d41586-023-04086-z","DOI":"10.1038\/d41586-023-04086-z"},{"key":"4121_CR42","unstructured":"Nau, R. (2020). Statistical forecasting: notes on regression and time series analysis. Fuqua School of Business, Duke University. Last updated: August 18 2020. https:\/\/people.duke.edu\/~rnau\/Decision411_2007\/411rand.htm. Last Accessed: September 24 2024."},{"issue":"1","key":"4121_CR43","doi-asserted-by":"publisher","first-page":"6800","DOI":"10.4081\/idr.2017.6800","volume":"9","author":"EJM Oberj\u00e9","year":"2017","unstructured":"Oberj\u00e9 EJM, Tanke MAC, Jeurissen PPT (2017) Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money. Infectious Disease Reports 9(1):6800. https:\/\/doi.org\/10.4081\/idr.2017.6800","journal-title":"Infectious Disease Reports"},{"key":"4121_CR44","doi-asserted-by":"publisher","unstructured":"Olesen SW, Barnett ML, MacFadden DR, Brownstein JS, Hern\u00e1ndez-D\u00edaz S, Lipsitch M, Grad YH (2018) The distribution of antibiotic use and its association with antibiotic resistance. eLife 7:e39435. https:\/\/doi.org\/10.7554\/eLife.39435","DOI":"10.7554\/eLife.39435"},{"key":"4121_CR45","doi-asserted-by":"publisher","unstructured":"Organization for Economic Cooperation and Development (OECD). (2024). Health at a Glance: Europe 2024: State of Health in the EU Cycle. OECD Publishing, Paris. Last updated: November 2024. Last Accessed: February 1 2025. https:\/\/doi.org\/10.1787\/b3704e14-en.","DOI":"10.1787\/b3704e14-en"},{"key":"4121_CR46","unstructured":"Python Package Index (pypi). (2023). Pmdarima. Pyothon\u2019s forecast:: auto.arima equivalent. Last updated: October 2023. Last Accessed: January 30 2025. https:\/\/pypi.org\/project\/pmdarima\/"},{"key":"4121_CR47","unstructured":"Python Package Index (pypi). (2024). openpyxl 3.1.5. pip install openpyxl. Last updated: Juny 2024. Last Accessed: January 30 2025. https:\/\/pypi.org\/project\/openpyxl\/#description"},{"key":"4121_CR48","doi-asserted-by":"publisher","unstructured":"Robertson J, Vlahovi\u0107-Pal\u010devski V, Iwamoto K, H\u00f6gberg LD, Godman B, Monnet DL, Garner S, Weist K, ESAC-Net Study Group, WHO Europe AMC Network Study Group. (2021). Variations in the Consumption of Antimicrobial Medicines in the European Region, 2014\u20132018: Findings and Implications from ESAC-Net and WHO Europe. Front Pharmacol.;12:639207. https:\/\/doi.org\/10.3389\/fphar.2021.639207","DOI":"10.3389\/fphar.2021.639207"},{"key":"4121_CR49","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s12961-020-00605-w","volume":"18","author":"AM Rotar","year":"2020","unstructured":"Rotar AM, van den Berg MJ, Klazinga NS (2020) An expert-based mapping of healthcare system strategies to support rational drug prescribing in primary care across 13 European countries. Health Res Policy Sys 18:102. https:\/\/doi.org\/10.1186\/s12961-020-00605-w","journal-title":"Health Res Policy Sys"},{"key":"4121_CR50","doi-asserted-by":"crossref","unstructured":"Seabold, S., Perktold, J. (2010). Statsmodels: Econometric and statistical modeling with Python. Proceedings of the 9th Python in Science Conference (SciPy 2010), Austin, TX, 28 June\u20133 July 2010, pp. 92\u201396. Last Accessed: January 30 2025. https:\/\/pub.curvenote.com\/01908379-2a1a-7a74-a157-6a0df64b92f2\/public\/seabold-34d6671a7bae7c2c09a284f57c0422d9.pdf","DOI":"10.25080\/Majora-92bf1922-011"},{"key":"4121_CR51","doi-asserted-by":"publisher","unstructured":"Spernovasilis, N., Tsioutis, C. (2024). Not surprising: a rebound in antibacterial consumption in Europe, with Cyprus and Greece on the podium. Journal of Antimicrobial Chemotherapy, Volume 79, Issue 5, May 2024, Pages 933\u2013934. https:\/\/doi.org\/10.1093\/jac\/dkae055","DOI":"10.1093\/jac\/dkae055"},{"key":"4121_CR52","doi-asserted-by":"publisher","first-page":"11387","DOI":"10.3389\/bjbs.2023.11387","volume":"80","author":"KWK Tang","year":"2023","unstructured":"Tang KWK, Millar BC, Moore JE (2023) Antimicrobial Resistance (AMR). Br J Biomed Sci 80:11387. https:\/\/doi.org\/10.3389\/bjbs.2023.11387","journal-title":"Br J Biomed Sci"},{"issue":"8","key":"4121_CR53","doi-asserted-by":"publisher","first-page":"e2326910","DOI":"10.1001\/jamanetworkopen.2023.26910","volume":"6","author":"F Tian","year":"2023","unstructured":"Tian F, Chen Z, Zeng Y, Feng Q, Chen X (2023) Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide: A Systematic Review and Meta-Analysis. JAMA Netw Open 6(8):e2326910. https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.26910","journal-title":"JAMA Netw Open"},{"key":"4121_CR54","unstructured":"United Nations (UN). (2024). UN General Assembly meeting on AMR in September 2024 - Political Declaration of the High-level Meeting on Antimicrobial Resistance. Last updated: September 9 2024. Last accessed: March 17 2025. https:\/\/www.un.org\/pga\/wp-content\/uploads\/sites\/108\/2024\/09\/FINAL-Text-AMR-to-PGA.pdf"},{"key":"4121_CR55","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s13756-018-0428-8","volume":"7","author":"J Wojkowska-Mach","year":"2018","unstructured":"Wojkowska-Mach J, Godman B, Glassman A, Kurdi A, Pilc A, Rozanska A, Skoczy\u0144ski S, Wa\u0142aszek M, Bochenek T (2018) Antibiotic consumption and antimicrobial resistance in Poland; findings and implications. Antimicrob Resist Infect Control 7:136. https:\/\/doi.org\/10.1186\/s13756-018-0428-8","journal-title":"Antimicrob Resist Infect Control"},{"key":"4121_CR56","unstructured":"World Health Organization (WHO). (2022). The WHO AWaRe (Access, Watch, Reserve) antibiotic book. Web Annex. Infographics. WHO\/MHP\/HPS\/EML\/2022.02. Licence: CC BY-NC-SA 3.0 IGO. Last updated: 2022. Last accessed: March 19 2025. https:\/\/iris.who.int\/bitstream\/handle\/10665\/365135\/WHO-MHP-HPS-EML-2022.02-eng.pdf?sequence=1"},{"key":"4121_CR57","unstructured":"World Health Organization (WHO). (2023). AWaRe classification of antibiotics for evaluation and monitoring of use, 2023. Last updated: July 2023. Last Accessed: January 22 2025. https:\/\/iris.who.int\/bitstream\/handle\/10665\/371093\/WHO-MHP-HPS-EML-2023.04-eng.xlsx?sequence=1"},{"key":"4121_CR58","unstructured":"World Health Organization (WHO). (2025b). Antibiotic use: Target \u226560% of total antibiotic use being Access group antibiotics (GPW13 target 4b). Indicator Metadata Registry List. Last updated: 2025. Last accessed: March 15 2025. https:\/\/www.who.int\/data\/gho\/indicator-metadata-registry\/imr-details\/5767"},{"key":"4121_CR59","unstructured":"World Health Organization (WHO). (2025a). WHO antibiotic categorization. WHO AWaRe Portal. Last Accessed: January 22 2025. https:\/\/aware.essentialmeds.org\/groups"},{"issue":"4","key":"4121_CR60","doi-asserted-by":"publisher","first-page":"290","DOI":"10.2471\/BLT.22.288614","volume":"101","author":"V Zanichelli","year":"2023","unstructured":"Zanichelli V, Sharland M, Cappello B, Moja L, Getahun H, Pessoa-Silva C, Sati H, van Weezenbeek C, Balkhy H, Sim\u00e3o M, Gandra S, Huttner B (2023) The WHO AWaRe (Access, Watch, Reserve) antibiotic book and prevention of antimicrobial resistance [Livre sur les antibiotiques AWaRe (Access, Watch, Reserve) de l\u2019OMS et pr\u00e9vention de la r\u00e9sistance aux antimicrobiens]. Bull World Health Organ 101(4):290\u2013296. https:\/\/doi.org\/10.2471\/BLT.22.288614","journal-title":"Bull World Health Organ"}],"updated-by":[{"DOI":"10.1007\/s00210-026-05776-x","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000}}],"container-title":["Naunyn-Schmiedeberg's Archives of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-04121-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00210-025-04121-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-04121-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:05:58Z","timestamp":1785438358000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00210-025-04121-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,12]]},"references-count":61,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["4121"],"URL":"https:\/\/doi.org\/10.1007\/s00210-025-04121-y","relation":{},"ISSN":["0028-1298","1432-1912"],"issn-type":[{"value":"0028-1298","type":"print"},{"value":"1432-1912","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,12]]},"assertion":[{"value":"14 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00210-026-05776-x","URL":"https:\/\/doi.org\/10.1007\/s00210-026-05776-x","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This research was conducted according to the guidelines of good scientific practice of the Hannover Medical School (\n                      \n                      . The Hannover Medical School follows the guidelines of the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable because publicly available information is used as a data source.","order":2,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"R.S. in the Editor-in-Chief of Naunyn-Schmiedebergs Arch Pharmacol and follows the editorial guidelines of editors acting as authors (\n                      \n                      ).","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}