Literature DB >> 22826031

Variation in antibiotic prescriptions: is area deprivation an explanation? Analysis of 1.2 million children in Germany.

D Koller1, F Hoffmann, W Maier, K Tholen, R Windt, G Glaeske.   

Abstract

PURPOSE: Inadequate use of antibiotics can lead to problems such as resistance. Overuse is especially a problem for children, since they are more affected by acute (often virus-caused) infections. While the problem has been addressed internationally over the past several years, regional variations in prescriptions are striking. Therefore, the present study aims to analyze regional variations in antibiotic prescription on a district level in Germany and tries to identify reasons for those variations through adding possible influencing factors to the analysis on individual and district levels.
METHODS: We analyzed 1.2 million children insured in a German health insurance fund. Antibiotic prescriptions were quantified in 2010 and reasons for prescriptions were analyzed in multilevel regressions based on the district of residence, regional deprivation, and age and sex of the child.
RESULTS: Thirty-six percent of all children aged 0-17 years received an antibiotic prescription in 2010. In the south, prevalences are generally lower, and also to the very north. The highest prevalences are found in the close-to-border districts in the west, as well as in a band throughout the middle of Germany, in rather low population density areas. Regional variation in the prevalence range from 19 to 53 % between districts. Regional deprivation can explain part of this variation.
CONCLUSIONS: Including area deprivation measures helped identify an influence of especially regional income and occupational deprivation on antibiotic prescriptions for children. Regional analysis such as this can help identify specific regions and groups of persons to address information programs on the risks of preventable antibiotic consumption and alternative treatment methods.

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Year:  2012        PMID: 22826031     DOI: 10.1007/s15010-012-0302-1

Source DB:  PubMed          Journal:  Infection        ISSN: 0300-8126            Impact factor:   3.553


  31 in total

1.  [Differences in antibiotic prescribing between general practitioners and pediatricians in Hesse, Germany].

Authors:  S Abbas; P Ihle; L Heymans; J Küpper-Nybelen; I Schubert
Journal:  Dtsch Med Wochenschr       Date:  2010-09-07       Impact factor: 0.628

2.  Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression.

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Journal:  Am J Epidemiol       Date:  2005-01-01       Impact factor: 4.897

3.  Influence of population structure on the consumption of systemic antibiotics.

Authors:  Enrique Pastor García; José María Eiros Bouza; Agustín Mayo Iscar; Rosario Bachiller
Journal:  Int J Antimicrob Agents       Date:  2005-01       Impact factor: 5.283

4.  Socioeconomic determinants of regional differences in outpatient antibiotic consumption: evidence from Switzerland.

Authors:  Massimo Filippini; Giuliano Masiero; Karine Moschetti
Journal:  Health Policy       Date:  2005-11-10       Impact factor: 2.980

5.  Diabetes 'epidemic' in Germany? A critical look at health insurance data sources.

Authors:  F Hoffmann; A Icks
Journal:  Exp Clin Endocrinol Diabetes       Date:  2012-03-22       Impact factor: 2.949

6.  Differences in outpatient antibiotic prescription in Italy's Lombardy region.

Authors:  C Franchi; M Sequi; M Bonati; A Nobili; L Pasina; A Bortolotti; I Fortino; L Merlino; A Clavenna
Journal:  Infection       Date:  2011-06-25       Impact factor: 3.553

7.  Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians.

Authors:  R Gonzales; J F Steiner; M A Sande
Journal:  JAMA       Date:  1997-09-17       Impact factor: 56.272

8.  Regional variation in outpatient antibiotic prescribing in Germany.

Authors:  W V Kern; K de With; K Nink; M Steib-Bauert; H Schröder
Journal:  Infection       Date:  2006-10       Impact factor: 3.553

9.  Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis.

Authors:  A C Nyquist; R Gonzales; J F Steiner; M A Sande
Journal:  JAMA       Date:  1998-03-18       Impact factor: 56.272

10.  Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

Authors:  Herman Goossens; Matus Ferech; Robert Vander Stichele; Monique Elseviers
Journal:  Lancet       Date:  2005 Feb 12-18       Impact factor: 79.321

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  23 in total

1.  High variability among Emergency Departments in 3rd-generation cephalosporins and fluoroquinolones use for community-acquired pneumonia.

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Journal:  Infection       Date:  2015-05-22       Impact factor: 3.553

2.  The Decline in Outpatient Antibiotic Use.

Authors:  Jakob Holstiege; Maike Schulz; Manas K Akmatov; Winfried V Kern; Annika Steffen; Jörg Bätzing
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3.  Outpatient Antibiotic Prescription.

Authors:  Jörg Bätzing-Feigenbaum; Maike Schulz; Mandy Schulz; Ramona Hering; Winfried V Kern
Journal:  Dtsch Arztebl Int       Date:  2016-07-01       Impact factor: 5.594

4.  Antibiotic prescribing for pediatric respiratory infections: What explains a large variation among physicians?

Authors:  Rachel McKay; David M Patrick; Kimberlyn McGrail; Michael R Law
Journal:  Can Fam Physician       Date:  2019-06       Impact factor: 3.275

5.  Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

Authors:  Sascha Abbas; Peter Ihle; Jürgen-Bernhard Adler; Susanne Engel; Christian Günster; Martin Holtmann; Axel Kortevoss; Roland Linder; Werner Maier; Gerd Lehmkuhl; Ingrid Schubert
Journal:  Eur Child Adolesc Psychiatry       Date:  2016-09-14       Impact factor: 4.785

6.  Trends in outpatient antibiotic use in Israel during the years 2000-2010: setting targets for an intervention.

Authors:  M Low; O Nitzan; H Bitterman; C Cohen; A Hammerman; N Lieberman; R Raz; R D Balicer
Journal:  Infection       Date:  2012-09-24       Impact factor: 3.553

7.  Systemic antibiotic use among children and adolescents in Germany: a population-based study.

Authors:  Jakob Holstiege; Edeltraut Garbe
Journal:  Eur J Pediatr       Date:  2013-02-10       Impact factor: 3.183

8.  Antibiotic and anti-asthmatic drug prescriptions in Italy: geographic patterns and socio-economic determinants at the district level.

Authors:  Daniele Piovani; Antonio Clavenna; Massimo Cartabia; Maurizio Bonati
Journal:  Eur J Clin Pharmacol       Date:  2013-12-06       Impact factor: 2.953

9.  Socioeconomic Status and Determinants of Pediatric Antibiotic Use.

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10.  Geographical epidemiology of antibacterials in the preschool age.

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Journal:  Int J Health Geogr       Date:  2012-12-14       Impact factor: 3.918

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