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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

1University of Montenegro, Faculty of Medicine, Department of Pharmacology and Clinical Pharmacology, Podgorica, Montenegro
2Clinical Center of Montenegro, Center for Laboratory Diagnostics, Podgorica, Montenegro
3University of Montenegro, Faculty of Science and Mathematics, Podgorica, Montenegro

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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.