Use of antibiotics in rural and urban regions in the Netherlands: an observational drug utilization study

BMC Public Health

Lolkje TW de Jong-van den Berg²  Tjalling W de Vries¹  Jens HJ Bos²  Josta de Jong² 

[1] Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands;Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, A. Deusinglaan 1, 9713AV Groningen, the Netherlands

关键词: Urban;    Rural;    Humans;    Bacterial resistance;    Cattle;    Antibiotics;   

Others  :  866321
DOI  :  10.1186/1471-2458-14-677

 received in 2014-02-10, accepted in 2014-06-27,  发布年份 2014

【 摘 要 】

Background

Large livestock farms might increase the infection risk for the nearby human population because of an increased risk for disease outbreaks and because antibiotic-resistant bacteria are more likely to be present. We hypothesized that populations residing in rural areas have more contact with cattle compared with populations in urban areas, and will use more antibiotics or more frequently require a new course of antibiotics.

Methods

Using data from the prescription database IADB.nl, we compared antibiotic use by patients living in rural areas to the use by patients living in urban areas. We also followed cohorts of antibiotic users and determined the patients who required a second antibiotic within 14 days after beginning the first antibiotic.

Results

The yearly prevalence of antibiotic use was greater in rural areas compared with urban areas (2009: 23.6% versus 20.2% (p < 0.001), especially in the younger age groups. More adult patients residing in rural areas required a second course of antibiotic treatment within 14 days after starting the first treatment.

Conclusion

Individuals use more antibiotics, and adults more frequently require a second antibiotic prescription within 14 days, in rural areas compared with urban areas. Although the differences were small and the risks for the general rural population were not high, this difference should be investigated further.

【 授权许可】

   
2014 de Jong et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]van der Meulen H, de Bont K, Agricola H, van Horne P, Hoste R, van der Knijff A, Leenstra F, van der Meer R, de Smet A: Schaalvergroting in de land- en tuinbouw. Effecten bij veehouderij en glastuinbouw. 2011.
• [2]Smit LA, van der Sman-de BF, Opstal-van Winden AW, Hooiveld M, Beekhuizen J, Wouters IM, Yzermans J, Heederik D: Q fever and pneumonia in an area with a high livestock density: a large population-based study. PLoS One 2012, 7(6):e38843.
• [3]van Cleef BA, Verkade EJ, Wulf MW, Buiting AG, Voss A, Huijsdens XW, van Pelt W, Mulders MN, Kluytmans JA: Prevalence of livestock-associated MRSA in communities with high pig-densities in The Netherlands. PLoS One 2010, 5(2):e9385.
• [4]Mulders MN, Haenen AP, Geenen PL, Vesseur PC, Poldervaart ES, Bosch T, Huijsdens XW, Hengeveld PD, Dam-Deisz WD, Great EA, Mevius D, Voss A, Van De Giessen AW: Prevalence of livestock-associated MRSA in broiler flocks and risk factors for slaughterhouse personnel in The Netherlands. Epidemiol Infect 2010, 138(5):743-755.
• [5]Rijks Instituut voor Volksgezondheid en Milieu (National Institute for Public Health and Environment): WIP-richtlijnen MRSA, ziekenhuis. 2012. Available at: http://www.rivm.nl/dsresource?objectid=rivmp:46603&type=org&disposition=inline webcite. Accessed 09/18, 2012
• [6]De Schrijver K, Buvens G, Posse B, Van den Branden D, Oosterlynck O, De Zutter L, Eilers K, Dierick K, Van Damme-Lombaerts R, Lauwers C, Jacobs R: Outbreak of verocytotoxin-producing E. coli O145 and O26 infections associated with the consumption of ice cream produced at a farm, Belgium, 2007. Euro Surveill 2008., 13(7)
• [7]Guh A, Phan Q, Nelson R, Purviance K, Milardo E, Kinney S, Mshar P, Kasacek W, Cartter M: Outbreak of Escherichia coli O157 associated with raw milk, Connecticut, 2008. Clin Infect Dis 2010, 51(12):1411-1417.
• [8]Visser ST, Schuiling-Veninga CC, Bos JH, de Jong-van den Berg LT, Postma MJ: The population-based prescription database IADB.nl: its development, usefulness in outcomes research and challenges. Expert Rev Pharmacoecon Outcomes Res 2013, 13(3):285-292.
• [9]WHO Collaborating Centre for Drug Statistic Methodology: Guidelines for ATC classification and DDD assignment. 2012. Available at: http://www.whocc.no/atc_ddd_index/ webcite. Accessed 05/30, 2012
• [10]Statistics Netherlands: Explanation of degree of urbanisation. Available at: http://www.cbs.nl/en-GB/menu/methoden/begrippen/default.htm?Languageswitch=on&ConceptID=658 webcite. Accessed 05-30, 2012
• [11]Kozyrskyj AL, Dahl ME, Chateau DG, Mazowita GB, Klassen TP, Law BJ: Evidence-based prescribing of antibiotics for children: role of socioeconomic status and physician characteristics. CMAJ 2004, 171(2):139-145.
• [12]Mangrio E, Wremp A, Moghaddassi M, Merlo J, Bramhagen AC, Rosvall M: Antibiotic use among 8-month-old children in Malmo, Sweden–in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors. BMC Pediatr 2009, 9:31.
• [13]Mulder M: Sociaaleconomische status 2010. Volksgezondheid Toekomst Verkenning, Dutch National Atlas of Public Health 2012. Available at: http://www.zorgatlas.nl/beinvloedende-factoren/sociale-omgeving/ses/sociaaleconomische-status/ webcite. Accessed 06/13, 2012
• [14]Kroneman M, Verheij R, Tacken M, van der Zee J: Urban-rural health differences: primary care data and self reported data render different results. Health Place 2010, 16(5):893-902.