Resistance to antibiotics is more common in southern and
Herman Goossens (University of Antwerp, Belgium) and colleagues compared antibiotic use with antibiotic resistance rates in 26 European countries from the beginning of 1997 to the end of 2002. To control for the different population sizes the investigators expressed data in defined daily dose per 1000 inhabitants daily (DID).
The study found that the prescription of antibiotics in primary care in Europe vary greatly. The highest rate was in France (32.2 DID) and the lowest was in the Netherlands (10.0 DID). Across
The authors believe the data will be useful for assessing public health strategies that aim to reduce inappropriate antibiotic use and resistance levels. In the article they write that the differences in antibiotic use between countries might be explained by variations in incidence of community infections, culture and education, differences in drug relations and in the structure of the national pharmaceutical market.
Professor Goossens concludes: Population-based studies are needed to determine the motivation and incentives that lead individuals to use or not to use antibiotics. The ethics of promoting antibiotics in clinical situations in which they are unnecessary should be given serious consideration. In view of the emergence of bacterial resistance and the decline in the rate of development of novel antibiotics, effective professional and public strategies to encourage appropriate prescribing of antibiotics should be studied and implemented. If not, we will lose the miracle drugs of the 20th century.
In an accompanying commentary, John Turnidge (Womens and Childrens Hospital,
Professor Turnidge comments: If we develop more sophisticated systems to measure antimicrobial use that incorporate the many influences, such as the proportion of individuals exposed, the proportion of children in the population, population densities, the effects of different drug classes, and the differences between bacterial species, it will help us to design and measure the success of intervention strategies.
Source: The Lancet