Antimicrobial Consumption in The Community Sector in Poland, 2019-2024: Changes and Challenges.

Abstract

Monitoring antibiotic consumption (AMC) in the community sector is essential for understanding prescribing patterns and informing national stewardship policies. This analysis presents recent trends in community antibiotic use in Poland from 2019 to 2024, focusing on temporal dynamics and progress toward the European Union's 2030 reduction targets. By 2030, there should be an overall reduction in AMC, with at least 65% of total AMC in humans accounted for by drugs from the WHO Access group, first- or second-line antibiotics for common infections with a narrower spectrum of action. Data on systemic antibacterials (ATC J01) were obtained from IQVIA Poland and expressed in defined daily doses per 1,000 inhabitants per day (DID). Antibiotic use in the community sector sharply declined in 2020 due to the COVID-19 pandemic, but then increased, surpassing pre-pandemic levels by 2022. By 2024, community consumption reached 21.2 DID, remaining significantly above the EU/EEA average. Penicillins (J01C) consistently accounted for the largest share of use, primarily due to broad-spectrum agents like amoxicillin-beta-lactamase inhibitor combinations (e.g., amoxicillin-clavulanic acid). The use of narrow-spectrum penicillins remained low. Macrolides (J01F) and cephalosporins and other beta-lactams (J01D) experienced a marked post-pandemic increase, while tetracyclines (J01A) and quinolones (J01M) remained relatively stable. In 2024, Access antibiotics comprised 57.3% total outpatient use, indicating that narrower-spectrum agents are underused in Poland. Our findings suggest that enhancing stewardship programs, improving access to microbiological diagnostic testing, and ensuring consistent adherence to infection-prevention measures will be crucial in achieving the EU and WHO 2030 goals.