{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T20:22:35Z","timestamp":1786393355676,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007660","name":"University of Antwerp","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>A decrease in community antibiotic consumption in Europe has been observed during the COVID-19 pandemic. The magnitude of this decrease, how fast after the outbreak it occurred, whether it was sustained during the pandemic and whether the seasonal variation in antibiotic consumption was affected, have not yet been evaluated in detail.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on community antibiotic consumption were available from the European Surveillance of Antimicrobial Consumption Network for 28 EU\/European Economic Area (EEA) countries between 2010 and 2021. Antibiotic consumption was expressed as DDDs per 1000 inhabitants per day (DID). The impact of the pandemic on antibiotic consumption was investigated using descriptive statistics and non-linear mixed changepoint models for quarterly and yearly data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The decrease in overall antibiotic consumption between 2019 and 2020 (\u22123.4 DID; \u221218.6%) was mainly due to a decrease in the consumption of penicillins [Anatomical Therapeutic Chemical (ATC) code J01C] (\u22121.9 DID; \u221223.0%), other \u03b2-lactam antibacterials (J01D) (\u22120.6 DID; \u221225.8%) and macrolides, lincosamides and streptogramins (J01F) (\u22120.5 DID; \u221217.4%) and was sustained during 2021. The changepoint analysis of yearly data (28 countries) estimated a decrease of 3.3 DID in overall antibiotic consumption (J01) between 2019 and 2020. The analysis of quarterly data (16 countries) estimated a decrease in overall antibiotic consumption (J01) of 4.0 DID and a decrease in seasonal variation of 1.2 DID between the first and second quarters of 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The changepoint analysis indicated a significant, sudden and steep decrease in community antibiotic consumption in the EU\/EEA immediately after the start of the COVID-19 outbreak in Europe, as well as a decrease in its seasonal variation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad273","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T11:46:00Z","timestamp":1694000760000},"page":"2572-2580","source":"Crossref","is-referenced-by-count":15,"title":["Impact of the COVID-19 pandemic on community antibiotic consumption in the EU\/European Economic Area: a changepoint analysis"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-511X","authenticated-orcid":false,"given":"Helene","family":"Vermeulen","sequence":"first","affiliation":[{"name":"Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Data Science Institute (DSI), Hasselt University , Hasselt , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-0637","authenticated-orcid":false,"given":"Niel","family":"Hens","sequence":"additional","affiliation":[{"name":"Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Data Science Institute (DSI), Hasselt University , Hasselt , Belgium"},{"name":"Department of Family Medicine and Population Health (FAMPOP), University of Antwerp , Antwerp , Belgium"},{"name":"Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp , Antwerp , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Catteau","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boudewijn","family":"Catry","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano , Brussels , Belgium"},{"name":"Faculty of Medicine, Universit\u00e9 libre de Bruxelles (ULB) , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1238-8052","authenticated-orcid":false,"given":"Samuel","family":"Coenen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health (FAMPOP), University of Antwerp , Antwerp , Belgium"},{"name":"Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp , Antwerp , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"2023100302093906200_dkad273-B1","author":"European Centre for Disease Prevention and Control (ECDC)"},{"key":"2023100302093906200_dkad273-B2","author":"World Health Organization (WHO)","year":"2020"},{"key":"2023100302093906200_dkad273-B3","author":"European Centre for Disease Prevention and Control (ECDC)"},{"key":"2023100302093906200_dkad273-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2807\/1560-7917.ES.2021.26.46.2101020","article-title":"Decrease in community antibiotic consumption during the COVID-19 pandemic, EU\/EEA, 2020","volume":"26","author":"H\u00f6gberg","year":"2021","journal-title":"Eurosurveillance"},{"key":"2023100302093906200_dkad273-B5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/jac\/dkab172","article-title":"Consumption of antibiotics in the community, European union\/European economic 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