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Drivers of Irrational Use of Antibiotics in Europe

Author

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  • Anna Machowska

    (Global Health-Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden)

  • Cecilia Stålsby Lundborg

    (Global Health-Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden)

Abstract

The unnecessary use of antibiotics and concomitant rapid growth of antibiotic resistance (ABR) is a widely acknowledged threat to global health, development, and sustainability. While the underlying cause of ABR is undoubtedly the overall volume of antibiotic use in general, irrational antibiotic use, which is influenced by several interrelated factors, is a major contributory factor. Here, we aimed to present and describe selected main drivers of irrational use of antibiotics in Europe. We performed a broad search of the current literature in databases such as PubMed, Google Scholar, Cochrane, as well as various institutional websites (World Health Organization, European Observatory, European Commission) to provide a new perspective on selected drivers of irrational antibiotic use in Europe. We also searched for relevant literature using snowballing, i.e., using reference lists of papers to identify additional papers. In this narrative review, we present that major factors among the general public driving antibiotic resistance are lack of public knowledge and awareness, access to antibiotics without prescription and leftover antibiotics, and knowledge attitude and perception of prescribers and dispensers, inadequate medical training, pharmaceutical promotion, lack of rapid and sufficient diagnostic tests, and patient–doctor interaction as major factors among healthcare providers. We further discuss initiatives that, if taken and implemented, can have an impact on and improve the current situation in Europe.

Suggested Citation

  • Anna Machowska & Cecilia Stålsby Lundborg, 2018. "Drivers of Irrational Use of Antibiotics in Europe," IJERPH, MDPI, vol. 16(1), pages 1-14, December.
    • Handle: RePEc:gam:jijerp:v:16:y:2018:i:1:p:27-:d:192700
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    References listed on IDEAS

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    1. Eglė Pavydė & Vincentas Veikutis & Asta Mačiulienė & Vytautas Mačiulis & Kęstutis Petrikonis & Edgaras Stankevičius, 2015. "Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania," IJERPH, MDPI, vol. 12(6), pages 1-15, June.
    2. Klaus Lieb & Armin Scheurich, 2014. "Contact between Doctors and the Pharmaceutical Industry, Their Perceptions, and the Effects on Prescribing Habits," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-8, October.
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    1. Virginie-Eve Lvovschi & Florence Carrouel & Benjamin du Sartz de Vigneulles & Michel Lamure & Geneviève Motyka & Laurie Fraticelli & Claude Dussart, 2022. "Knowledge, Attitudes and Practices Related to Medication, Antibiotics, and Vaccination among Public Service Population: National Survey Conducted in France," IJERPH, MDPI, vol. 19(21), pages 1-20, October.
    2. Mona Katrine Alberthe Holm & Filip Jansåker & Kim Oren Gradel & Rikke Thoft Nielsen & Christian Østergaard Andersen & Jens Otto Jarløv & Henrik Carl Schønheyder & Jenny Dahl Knudsen, 2021. "Decrease in All-Cause 30-Day Mortality after Bacteraemia over a 15-Year Period: A Population-Based Cohort Study in Denmark in 2000–2014," IJERPH, MDPI, vol. 18(11), pages 1-12, June.
    3. Wang, Sophie Y. & Cantarelli, Paola & Groene, Oliver & Stargardt, Tom & Belle, Nicola, 2023. "Patient expectations do matter - Experimental evidence on antibiotic prescribing decisions among hospital-based physicians," Health Policy, Elsevier, vol. 128(C), pages 11-17.
    4. Stefan Borgmann & Beate Rieß & David Meintrup & Ingo Klare & Guido Werner, 2020. "Long-Lasting Decrease of the Acquisition of Enterococcus faecium and Gram-Negative Bacteria Producing Extended Spectrum Beta-Lactamase (ESBL) by Transient Application of Probiotics," IJERPH, MDPI, vol. 17(17), pages 1-15, August.

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