Socio-economic determinants of outpatient antibiotic consumption in Europe

Outpatient antibiotic consumption widely vary across Europe. The investigation of what lies behind such variation may help to identify sources of inefficiency. Comparable data on antibiotic use in 21 European countries between 1997 and 2005 are provided by the European Surveillance of Antimicrobial Consumption (ESAC). Data on determinants are available for 17 countries between 2000 and 2005. We estimate an ad-hoc econometric model to assess the impact of socio-economic determinants of antibiotic consumption and the role played by bacterial resistance knowledge. The population income, the demographic structure, the density of general practitioners and their remuneration method appear to be significant determinants of antibiotic consumption. Although countries with higher levels of bacterial resistance exhibit significantly higher levels of per capita antibiotic use, ceteris paribus, the responsiveness of antibiotic use to changes in bacterial resistance is relatively low (0.009-0.015). This may suggest that the dissemination of information on bacterial resistance across Europe lacks effectiveness. Next to guidelines on appropriate use of antibiotics and awareness campaigns, economic incentives to general practitioners may provide opportunities for additional policy instruments to increase efficiency in antibiotic consumption.