For most urban residents, antibiotic use is greater than for people in rural areas. Children and older people also use theseMedication more frequentlyas young adults. Antibiotic use decreases as education increases, but only in rich countries. These are three of the most striking trends that researchers from the NRW research college “One Health and Urban Transformation” at the University of Bonn identified in a recent study.
Use of antibiotics in society
The researchers evaluated 73 publications on the use of antibiotics in outpatient settings worldwide. The topic is of great importance. Doctors are currently still prescribing too many antibiotic medicines. Possible consequences will most likely take the form of bacterial resistance. There is already hardly any protection against some viruseseffective medications. The scientists will soon publish the study in the International Journal of Hygiene and Environmental Health. However, this is already available online.
MostPatients often take antibiotics, without their illness requiring hospitalization. In Germany, these cases account for around 85 percent of all prescriptions. Across the EU, the rate is actually slightly higher. But what factors promote the use of antibiotics in the outpatient healthcare sector? Scientists have been interested in this question for some time. It is largely undisputed that overall too many of them are used as antidotes. This promotes the development of resistance and thus ensures that these weapons, which are actually the sharpest tools against bacterial infections, are gradually blunted.
The current study summarizes the current state of knowledge on this topic. The scientists involved evaluated a total of 73 publications on the driving factors of antibiotic consumption in the general population. “We were not only interested in individual parameters such as age or education, but also in geographical contexts and socio-cultural factors.” This is explained by Dennis Schmiege, who is doing his doctorate at the University of Bonn (Center for Development Research [ZEF]).
Study results
Together with his colleague: Timo Falkenberg, Dennis evaluated almost 600 variables and classified them into around 45 groups. The review article lists for each of the groups whether, based on current findings, they can be viewed as potentially influencing factors. There is relatively good evidence that children and seniors take antibiotics more often than middle-aged people. In contrast, a higher level of education tends to have a limiting effect. In poorer countries, however, this association is reversed - "probably because there it is more likely that well-educated people either have access to the health system or can afford to see a doctor or buy a medication at all," Schmiege assumes.
Among the geographical parameters, the discrepancy between urban and rural areas is striking: several publications show that the use of antibiotics is higher in urban areas. “We suspect that this has something to do with better access to doctor’s offices and pharmacies,” explains Schmiege. Indeed, physician concentration also appears to be one of the driving factors. In contrast, higher drug prices reduce the amount of antibiotics sold.
There is still comparatively little research into which sociocultural parameters promote the use of antibiotics. National culture appears to have some influence: for example, citizens of “masculine” societies that are considered more competitive use more antibiotics on average. The situation is similar in societies traditionally viewed as avoiding uncertainty. “Overall, however, we still see a clear need for research in this area,” emphasizes Dennis Schmiege.
Elsewhere, the study situation also shows a clear imbalance: low- and middle-income countries are significantly underrepresented compared to higher-income countries. This is another pointStudy, which the scientist believes future research projects should help resolve.
