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Ambulatory Care

In the outpatient sector in Switzerland, approximately 4.5 million packages of antibiotics are sold yearly. That’s more than one package per household.

Antibiotic consumption in the outpatient sector has slightly decreased since 2016.

The total consumption of antibiotics for systemic use (ATC group J01) in the outpatient sector, summed up to 9.0 defined daily doses (DDD) per 1000 inhabitants per day in 2018. The prescriptions of antibiotics in the outpatient sector have slightly decreased in all regions since 2016. Higher antibiotic consumption levels in the French and the Italian-speaking parts of Switzerland may be caused by characteristic prescription cultures in different linguistic regions.

Prescriptions of antibiotics, which are reserved for limited indications (WATCH Group) are decreasing.

The World Health Organisation (WHO) has developed a classification system for antibiotics which divides existing antibiotics into three categories: Access, Watch and Reserve (“AWaRe”) [1]. Antibiotics from the “Access” category should be preferred in general due to their effectiveness and their moderate contribution to the development of resistances compared with other antibiotics. The “Watch” category includes antibiotics which are only indicated for a limited number of infections, while “Reserve” antibiotics are only used as a last resort. Outpatient sales of “Access” antibiotics have been largely stable, “Watch” group sales have decreased in recent years and “Reserve” Antibiotics are generally not used in the outpatient sector.

Penicillins in combination with a beta-lactamase inhibitor are the most frequently prescribed antibiotics.

The most frequently used antibiotics in the outpatient sector in 2018 were penicillins in combination with a beta-lactamase inhibitor (26%; ATC=J01CR), i.e. almost exclusively amoxicillin clavulanic acid. Tetracyclines (15%), fluoroquinolones (13%), macrolides (12%) and penicillins with a broad spectrum of activity (11%) are also frequently used in the outpatient sector.

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