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:

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.
How antibiotics help spread resistance
Bacteria can become insensitive to antibiotics by picking up resistance genes from the environment.

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

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.