Socio-economic disparities in the dispensation of antibiotics in Sweden 2016-2017: An intersectional analysis of individual heterogeneity and discriminatory accuracy.

Maria Wemrell,Cecilia Lenander,Juan Merlo,Raquel Vicente Perez,Katarina Hedin,Kristofer Hansson

doi:10.1177/1403494820981496

Maria Wemrell, Cecilia Lenander + Show 4 more

Open Access

https://doi.org/10.1177/1403494820981496

Copy DOI

Abstract

Aims: Antimicrobial resistance presents an increasingly serious threat to global public health, which is directly related to how antibiotic medication is used in society. Actions aimed towards the optimised use of antibiotics should be implemented on equal terms and according to the needs of the population. Previous research results on differences in antibiotic use between socio-economic and demographic groups in Sweden are not entirely coherent, and have typically focused on the effects of singular socio-economic variables. Using an intersectional approach, this study provides a more precise analysis of how the dispensation of antibiotic medication was distributed across socio-economic and demographic groups in Sweden in 2016–2017. Methods: Using register data from a nationwide cohort and adopting an intersectional analysis of individual heterogeneity and discriminatory accuracy, we map the dispensation of antibiotics according to age, sex, country of birth and income. Results: While women and high-income earners had the highest antibiotic dispensation prevalence, no large differences in the dispensation of antibiotics were identified between socio-economic groups. Conclusions: Public-health interventions aiming to support the reduced and optimised use of antibiotics should be directed towards the whole Swedish population rather than towards specific groups. Correspondingly, an increased focus on socio-economic or demographic factors is not warranted in interventions aimed at improving antibiotic prescription patterns among medical practitioners.

Highlights

Antimicrobial resistance (AMR) presents an increasingly serious threat to global public health, which is directly related to how antibiotic medication is used in society [1]
In Sweden, while the situation is favourable in comparison to many other countries, and the number of annual prescriptions per capita has decreased over recent years [2], actions aiming towards the optimisation of antibiotic use are still warranted
Against the background of inconsistent research results on differences in antibiotic dispensation between groups, and the importance of such knowledge due to its potential implications for interventions targeted towards prescribers and the public, this study aimed to provide a more precise mapping of how the dispensation of antibiotics is distributed across socioeconomic and demographic groups in Sweden

Summary

Introduction

Antimicrobial resistance (AMR) presents an increasingly serious threat to global public health, which is directly related to how antibiotic medication is used in society [1]. In Sweden, while the situation is favourable in comparison to many other countries, and the number of annual prescriptions per capita has decreased over recent years [2], actions aiming towards the optimisation of antibiotic use are still warranted. We know that differences in antibiotic prescription patterns have existed between counties within the EU [4,5], between parts of Sweden [2,6] and between socioeconomic and demographic groups [7,8]. It has been noted that in public debates, responsibility and blame for AMR sometimes tend to be assigned to specific groups in society [9,10].

Methods

Results

Conclusion