Nav: Home

Antibiotics: City dwellers and children take the most

March 11, 2020

City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg "One Health and Urban Transformation" at the University of Bonn in a recent study. They evaluated 73 publications on the use of antibiotics in the outpatient sector around the world. The subject is of great importance: Too many antibiotics are still being administered. Possible consequences are resistances: Already there are hardly any effective drugs available against some bacteria. The study will be published in May in the International Journal of Hygiene and Environmental Health, but is already available online.

Most antibiotics are taken by patients whose illness does not require hospitalization. In Germany, these cases account for about 85 percent of all prescriptions; EU-wide the rate is even slightly higher. But what factors promote the use of antibiotics in the outpatient health sector? Scientists have been interested in this question for some time. It is largely undisputed that too many antibiotics are used overall. This promotes the development of resistances and thus ensures that these weapons, which are actually the sharpest tools against bacterial infections, are gradually blunted.

The current study summarizes the present state of knowledge on this issue. The scientists involved evaluated a total of 73 publications on the driving factors of antibiotic use in the general population. "We were interested not only in individual parameters such as age or education, but also in geographical contexts and socio-cultural factors," explains Dennis Schmiege, who is pursuing his doctorate at the University of Bonn (Center for Development Research (ZEF)) under supervision of Prof. Mariele Evers (Department of Geography) and Prof. Thomas Kistemann (Institute for Hygiene and Public Health).

600 possible influencing variables evaluated

Together with his colleague Dr. Timo Falkenberg, he evaluated almost 600 variables and arranged them into about 45 groups. For each of the groups, the review paper lists whether they are to be considered potentially influencing factors according to current findings. There is relatively good evidence that children and seniors are more likely to take antibiotics than middle-aged people. In contrast, a higher level of education tends to have a restraining effect. However, this association is reversed in poorer countries - "probably because there it is more likely to be the well-educated people who either have access to the health system or who can afford to visit a doctor or buy a drug in the first place," assumes Schmiege.

Among the geographical parameters the discrepancy between urban and rural areas stands out: 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 doctors' surgeries and pharmacies," explains Schmiege. The concentration of doctors indeed appears to be also one of the driving factors. In contrast, higher drug prices reduce the amount of antibiotics sold.

There is still comparatively little research on which socio-cultural parameters promote the use of antibiotics. National culture seems to have a certain influence: For example, citizens of "masculine" societies, which are considered to be more competitive, use more antibiotics on average. The situation is similar in societies that are traditionally considered to avoid 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: Lower- and middle-income countries are clearly underrepresented compared to richer ones, which is another point that future research projects should help to remedy, the scientist believes.
-end-
The study was conducted within the framework of the NRW Forschungskolleg "One Health and Urban Transformation", which is a graduate school funded by the Ministry of Culture and Science of NRW. It is conducted by the University of Bonn in cooperation with Hochschule Bonn-Rhein-Sieg, University of Applied Sciences (H-BRS) and the United Nations University - Institute for Environment and Human Security (UNU-EHS) in Bonn. Further information on the Forschungskolleg is available on the website http://www.zef.de/onehealth.html.

Publication: Dennis Schmiege, Mariele Evers, Thomas Kistemann and Timo Falkenberg: What drives antibiotic use in the community? A systematic review of determinants in the human outpatient sector; International Journal of Hygiene and Environmental Health; https://doi.org/10.1016/j.ijheh.2020.113497

Contact:

Dennis Schmiege Forschungskolleg „One Health and Urban Transformation" Center for Development Research (ZEF) University of Bonn Tel. +49-(0)228-736719 E-mail: d.schmiege@uni-bonn.de

University of Bonn

Related Antibiotics Articles:

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.
Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.
Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.
Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.
Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.
Antibiotics with novel mechanism of action discovered
Many life-threatening bacteria are becoming increasingly resistant to existing antibiotics.
Resistance can spread even without the use of antibiotics
Antibiotic resistance does not spread only where and when antibiotics are used in large quantities, ETH researchers conclude from laboratory experiments.
Selective antibiotics following nature's example
Chemists from Konstanz develop selective agents to combat infectious diseases -- based on the structures of natural products
Antibiotics can inhibit skin lymphoma
New research from the LEO Foundation Skin Immunology Research Center at the University of Copenhagen shows, surprisingly, that antibiotics inhibit cancer in the skin in patients with rare type of lymphoma.
Antibiotics may treat endometriosis
Researchers at Washington University School of Medicine in St. Louis have found that treating mice with an antibiotic reduces the size of lesions caused by endometriosis.

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Our Relationship With Water
We need water to live. But with rising seas and so many lacking clean water – water is in crisis and so are we. This hour, TED speakers explore ideas around restoring our relationship with water. Guests on the show include legal scholar Kelsey Leonard, artist LaToya Ruby Frazier, and community organizer Colette Pichon Battle.
Now Playing: Science for the People

#568 Poker Face Psychology
Anyone who's seen pop culture depictions of poker might think statistics and math is the only way to get ahead. But no, there's psychology too. Author Maria Konnikova took her Ph.D. in psychology to the poker table, and turned out to be good. So good, she went pro in poker, and learned all about her own biases on the way. We're talking about her new book "The Biggest Bluff: How I Learned to Pay Attention, Master Myself, and Win".
Now Playing: Radiolab

Uncounted
First things first: our very own Latif Nasser has an exciting new show on Netflix. He talks to Jad about the hidden forces of the world that connect us all. Then, with an eye on the upcoming election, we take a look back: at two pieces from More Perfect Season 3 about Constitutional amendments that determine who gets to vote. Former Radiolab producer Julia Longoria takes us to Washington, D.C. The capital is at the heart of our democracy, but it's not a state, and it wasn't until the 23rd Amendment that its people got the right to vote for president. But that still left DC without full representation in Congress; D.C. sends a "non-voting delegate" to the House. Julia profiles that delegate, Congresswoman Eleanor Holmes Norton, and her unique approach to fighting for power in a virtually powerless role. Second, Radiolab producer Sarah Qari looks at a current fight to lower the US voting age to 16 that harkens back to the fight for the 26th Amendment in the 1960s. Eighteen-year-olds at the time argued that if they were old enough to be drafted to fight in the War, they were old enough to have a voice in our democracy. But what about today, when even younger Americans are finding themselves at the center of national political debates? Does it mean we should lower the voting age even further? This episode was reported and produced by Julia Longoria and Sarah Qari. Check out Latif Nasser's new Netflix show Connected here. Support Radiolab today at Radiolab.org/donate.