Control of antibiotic use in the community: The Danish experience

The selection pressure for antibacterial resistance in the community might not be as high as in hospitals. However, it is generally accepted that it i s in the primary healthcare sector that one can achieve the greatest decrea se in the total use of antimicrobials. There are significant differences in the overall use of antimicrobials among European countries. On average, 80 % to 90% of the total antibiotic use in each country takes place in the pri mary healthcare sector. Surveillance of the use of antimicrobials is the co re for planning interventions and monitoring their effect. These interventi ons may be implemented for either political, economic, or professional reas ons. Often, but not always, political interventions are governmental, and p rofessional interventions are recommendations from professional association s. Examples of interventions at different levels in the Danish healthcare s ystem, from the general practitioner to legislation by the government, will be presented together with their effect on the use of antimicrobials (Infe ct Control Hosp Epidemiol 2000;21:387;389).