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Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Background

Antibiotic utilisation varies profoundly among and within countries, and the extent of antibiotic utilisation correlates with the frequency of bacterial resistance, particularly among children. Hence, it is important to assess which factors may influence prescribing. In addition to variations in morbidity, health-care organisation, drug regulatory and supply systems, prescriber's attitudes, parents' behaviour, attitudes and socio-economic positions seem important. We compared socio-economic position (educational level of adults) and antibiotic utilisation in children in the municipalities within a Danish and a Swedish county which are geographically close, have similar social and economic development, and similar drug regulatory and supply systems.

Methods

Data on antibiotic utilisation (1998), expressed in defined daily doses per 1000 inhabitants per day (DDD/TID), were obtained from the Copenhagen County Health Insurance register and from the National Corporation of Swedish Pharmacies. Data on municipal educational levels were obtained from Statistics Denmark and Statistics Sweden.

Results

The utilisation of antibiotics in 0- to 6-year-old children was higher in the Swedish than in the Danish county but varied between the municipalities within both the Swedish (9.6–17.7 DDD/TID) and the Danish (8.0–12.9 DDD/TID) counties. Most notably, utilisation rates correlated negatively with the education levels in the Danish (r=−0.539, P=0.021) but positively in the Swedish (r=+0.390, P=0.025) municipalities.

Conclusion

The observed variations in antibiotic prescribing may reflect different parental and/or prescriber attitudes towards use of antibiotics and they emphasise that antibiotic prescribing is influenced by factors other than the prevalence of bacterial infections. Relationships between socio-economic position (educational level) and drug utilisation should not be generalised from one area to another.

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Acknowledgement

This work was supported by a grant from the Knut and Alice Wallenberg's Foundation and by the NEPI Foundation.

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Authors and Affiliations

  1. Department of Clinical Microbiology and Immunology, Lund University Hospital, 221 85 , Lund, Sweden

    Eva Melander

  2. Copenhagen County, Denmark

    Aase Nissen

  3. Hospital Pharmacy, Malmö University Hospital, Sweden

    Karin Henricson

  4. Department of Community Medicine, Malmö University Hospital, Sweden

    Juan Merlo & Arne Melander

  5. The NEPI Foundation, Malmö, Sweden

    Juan Merlo, Sigvard Mölstad & Arne Melander

  6. Unit of Research and Development, Primary Health Care, Jönköping County, Sweden

    Sigvard Mölstad

  7. Institute for Rational Pharmacotherapy, Copenhagen, Denmark

    Jens P. Kampmann

  8. Epidemiology Unit, Region Skåne, Lund, Sweden

    Thor Lithman

  9. Department of Social Pharmacy, Pharmaceutical University of Denmark, Copenhagen, Denmark

    Ebba Holme Hansen

  10. FKL—Research Centre for Quality In Medicine Use, Copenhagen, Denmark

    Ebba Holme Hansen

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  1. Eva Melander
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  2. Aase Nissen
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  3. Karin Henricson
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  4. Juan Merlo
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  9. Arne Melander
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Correspondence to Eva Melander.

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Melander, E., Nissen, A., Henricson, K. et al. Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties. Eur J Clin Pharmacol 59, 331–335 (2003). https://doi.org/10.1007/s00228-003-0624-0

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  • DOI: https://doi.org/10.1007/s00228-003-0624-0

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