Antimicrobial consumption in Europe is monitored by a network of national surveillance networks in the European Union and European Economic Area (EEA)/European Free Trade Association (EFTA) countries through annual data calls. The national networks will upload the data to a central database (The European Surveillance System - TESSy) maintained at ECDC. After uploading, each country will approve its own data and the results will be made available from the ECDC website.

The former ESAC (European Surveillance of Antimicrobial Consumption) subprojects that collected data on antimicrobial use in hospitals and in long-term care facilities are continued by ECDC within the following activities of the Healthcare-Associated Infections Surveillance Network (HAI-Net):

  • data on the prevalence of antimicrobial use in residents at long-term care facilities are collected by the ECDC- funded HALT-2 project.

ECDC continues to produce comparable surveillance data on antimicrobial consumption in the community and in the hospital sector in European Union and EEA/EFTA countries.

The WHO Anatomical Therapeutic Chemical (ATC) classification system is used for the allocation of antimicrobials into groups.

ECDC collects data at national level and intends to collect sub-national data based on the NUTS classification.

Data on antimicrobial consumption are collected at the product level and the antimicrobials under surveillance are:

  • Antibacterials for systemic use (ATC group J01);
  • Antimycotics for systemic use (ATC group J02);
  • Antimycobacterials (ATC group J04);
  • Antivirals for systemic use (ATC group J05).

Antimicrobial consumption data from European Union and EEA/EFTA countries are expressed as a number of WHO Defined Daily Doses (DDD) per 1,000 inhabitants and per day. Complementary to this measurement unit, the number of packages per 1,000 inhabitants and per day also are reported depending on the availability of data on packages from the national surveillance networks. Information on packages is deemed to improve the understanding and interpretation of differences in the levels and trends in antimicrobial consumption observed between and within countries, as the ATC/DDD system cannot take into account changes in package content.

For the denominator, population data from EUROSTAT, or from national statistic reports, are used. When consumption data do not cover the whole population, countries will provide data on the population covered by antimicrobial consumption surveillance data.

To maintain and facilitate data reporting, ECDC ensures:

  • validation of community and hospital sector data, including data from the national drug registers derived from national surveillance networks;
  • analysis of the trends in antimicrobial consumption overall and in the different ATC groups, as well as comparisons between countries and regions;



Link to European IC/HH Core Competencies: Area 3. Surveillance and investigation of healthcare associated infection (HAI)