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OUTPATIENT UTILIZATION OF ANTIBACTERIAL DRUGS FOR SYSTEMIC USE IN MONTENEGRO IN 2000-2022: HOW FAR ARE WE FROM VALUES AND TARGETS OF THE EUROPEAN UNION?

NATASA DUBORIJA-KOVACEVIC *1, JANA DJAPIC-SAVELIC ^1,2, ANDJELA MIJANOVIC 3

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This retrospective pharmacoepidemiologic study aimed to analyse outpatient utilisation of antibacterials for systemic use (ASU) in Montenegro in 2000 - 2022, comparing it with EU/EEA data to identify areas for improvement. Quantitative and qualitative indicators, such as defined daily dose per thousand inhabitants per day, drug utilisation 90%, distribution between broad- and narrow-spectrum ASU and AWaRe classification, were used. ASU were classified according to the ATC classification. Appropriate statistical tests were applied, using a significance level of α = 0.05 and R software for analysis. The use of ASU in Montenegro increased by 71% in 2022 compared to 2000. A significant difference was found in the use of certain antibiotic sub-groups (p < 0.05). Cephalosporins were used significantly more in Montenegro compared to the EU/EEA (p < 0.05). A nearly 10-fold increase in the ratio of broad- to narrow-spectrum ASU utilisation (0.24 vs. 1.96) was found. The utilisation of the Access group decreased from 73% in 2000 to 50% in 2022 (p < 0.05); that was lower compared to the mean value in the EU/EEA. Although the increase in outpatient ASU consumption in Montenegro was in line with the unfavourable global trend, it was opposite to the majority of EU/EEA countries and requires additional analyses and interventions.