Analysis of the National Antifungal Consumption Data of Turkey During 2013-2019

Abstract

Introduction: Monitoring antimicrobial consumption is important to encourage the prudent use of antifungal drugs and to minimize antifungal selective pressure. There is limited data on the national consumption of systemic antifungals in Turkey. This study aimed to investigate the antifungal consumption data of Turkey in ambulatory care and inpatients during 2013-2019 and to compare the consumption data of systemic antifungals in Turkey to that of European countries in 2019. Materials and Methods: Data were obtained retrospectively from the records of the Medicines and Medical Devices Agency of Turkey. The consumption of systemic antifungals according to the Anatomical Therapeutic Chemical (ATC) was calculated using the ATC/Defined Daily Dose (DDD) methodology. In addition, the systemic antifungals consumption data of European countries in 2019 according to eCDC was obtained and compared with that of Turkey obtained in this study expressed in [Defined Inhabitant Dose (DID) - DDD per 1000 inhabitants daily]. Results: Terbinafine (overall median DID: 0.5288), itraconazole (DID: 0.1648), and fluconazole (DID: 0.1068) were the most consumed agents in the outpatient setting. Azoles (DID: 0.0291) were the most commonly consumed agent in inpatients setting, followed by amphotericin-B (DID: 0.0173) and echinocandins (DID: 0.0051). Total antifungal consumption in Turkey was 1.52 DID for outpatients and 0.08 DID for inpatients in 2019. Conclusion: To the best of our knowledge, this study reported the national antifungal consumption data of Turkey for the first time. Antifungals use among outpatients in Turkey showed a decreasing trend from 2016 to 2019 compared to consumption between 2013 and 2016. However, Turkey is still one of the leading antifungal consumers among European countries, especially in ambulatory care.

Keywords

• systemic antifungals
• antifungal consumption
• national data
• outpatients
• inpatients
• turkey