About the network
ESAC-Net (formerly ESAC) is a Europe-wide network of national surveillance systems, providing European reference data on antimicrobial consumption. ESAC-Net collects and analyses data on antimicrobial consumption from EU and EEA/EFTA countries, both in the community and in the hospital sector.
The collected data are used to provide timely information and feedback to EU and EEA/EFTA countries on indicators of antimicrobial consumption. These indicators provide a basis for monitoring the progress of EU and EEA/EFTA countries towards prudent use of antimicrobials.
The coordination of ESAC-Net was transferred from the University of Antwerp, Belgium to the European Centre for Disease Prevention and Control in July 2011.
Data collection and analysis
The European Surveillance of Antimicrobial Consumption Network (ESAC-Net) continues collecting reference data on the consumption of antimicrobials for systemic use in the community and in the hospital sector in EU and EEA/EFTA countries through the European Surveillance System (TESSy).
The former ESAC subprojects that collected data on antimicrobial use in hospitals and in long-term care facilities are continued by ECDC within the following activities of the Healthcare-Associated Infections Surveillance Network (HAI-Net):
What surveillance data will be collected?
ECDC will continue to produce comparable surveillance data on antimicrobial consumption in the community and in the hospital sector in EU and EEA/EFTA countries. The data sources will be national sales and reimbursement data, including information from national drug registers.
ECDC will collect data at national level and intends to collect sub-national data based on the NUTS classification
Data on antimicrobial consumption will be collected at the product level and the antimicrobials under surveillance will be:
- Antibacterials for systemic use (ATC group J01);
- Antimycotics for systemic use (ATC group J02);
- Antimycobacterials (ATC group J04);
- Antivirals for systemic use (ATC group J05)
In addition, a few other antimicrobials outside of ATC group J will also be collected to complete the picture of antimicrobial consumption in Europe.
How will the data be collected, processed and expressed?
Antimicrobial consumption in Europe is monitored by a network of national surveillance networks in the EU and EEA/EFTA countries through annual data calls.
The national networks will upload the data to a central database (The European Surveillance System - TESSy) maintained at ECDC. After uploading, each country will approve its own data and the results will be made available from the ECDC website.
Antimicrobial consumption data from EU and EEA/EFTA countries will be expressed as a number of WHO Defined Daily Doses
(DDD) per 1,000 inhabitants and per day.
Complementary to this measurement unit, the number of packages per 1,000 inhabitants and per day will also be reported depending on the availability of data on packages from the national surveillance networks. Information on packages is deemed to improve the understanding and interpretation of differences in the levels and trends in antimicrobial consumption observed between and within countries, as the ATC/DDD system cannot take into account changes in package content.
For the denominator, population data from EUROSTAT, or from national statistic reports, will be used. When consumption data do not cover the whole population, countries will provide data on the population covered by antimicrobial consumption surveillance data.
To maintain and facilitate data reporting, ECDC will ensure:
- Validation of community and hospital sector data, including data from the national drug registers derived from national surveillance networks;
- Analysis of the trends in antimicrobial consumption overall and in the different ATC groups, as well as comparisons between countries and regions;
- Public access to information on antimicrobial consumption in Europe through an ESAC-Net interactive database.
ESAC-Net management and coordination
ESAC-Net is managed and coordinated by ECDC and supported by a Coordination Group composed of experts selected among the nominated ESAC-Net contact points.
National institutions/organisations participating in ESAC-Net
For inquiries on ESAC-Net and its website, please contact the ESAC-Net contact persons at the European Centre for Disease Prevention and Control (ECDC).
In case of technical problems or for any inquiries/feedback about the ESAC-Net interactive database, please contact the TESSy Helpdesk.
Email TESSy Helpdesk
The European Surveillance of Antimicrobial Consumption (ESAC) project started in November 2001 and was funded by two successive grants provided by the European Commission, Directorate-General Health & Consumers (SANCO) to the University of Antwerp, Belgium. From 2007-2011, ESAC was funded through a grant provided by the European Centre for Disease Prevention and Control (ECDC) (Grant Agreement GRANT/2007/001) to the University of Antwerp.
ESAC developed and maintained a comprehensive and comparable database for on-going surveillance of antimicrobial consumption in Europe. Data were collected from the 27 EU Member States, 3 EEA/EFTA countries (Iceland, Norway and Switzerland), the 3 candidate countries at the time (Croatia, the former Yugoslav Republic of Macedonia and Turkey) and 2 other non EU countries (Israel and the Russian Federation).
Starting in 2004, ESAC introduced sub-projects that focused on the following activities:
- In-depth study of antimicrobial consumption in the community and in the hospital sector;
- Web-based point-prevalence surveys of antibiotic prescribing in hospitals and in long-term care facilities;
- Analysis of the socio-economic determinants of antimicrobial consumption in the community.
In addition, indicators of appropriate antibiotic prescribing in primary care were developed. The ESAC data were used to explain the variation of antibiotic resistance in Europe and to assess the impact of interventions in the community.
The European Surveillance of Antimicrobial Consumption (ESAC) reports and relevant peer-reviewed journals (with surveillance data on antimicrobial consumption from ESAC and the results of the ESAC sub-projects) are available in the archived ESAC-Net documents.
Since July 2011, ESAC is integrated into ECDC surveillance activities as the European Surveillance of Antimicrobial Consumption Network (ESAC-Net).