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Review
. 2002 Dec;8(12):1460-7.
doi: 10.3201/eid0812.010533.

Outpatient antibiotic use and prevalence of antibiotic-resistant pneumococci in France and Germany: a sociocultural perspective

Stephan Harbarth  1 , Werner Albrich, Christian Brun-Buisson
Affiliations
Review

Outpatient antibiotic use and prevalence of antibiotic-resistant pneumococci in France and Germany: a sociocultural perspective

Stephan Harbarth et al. Emerg Infect Dis. 2002 Dec.

Abstract

The prevalence of penicillin-nonsusceptible pneumococci is sharply divided between France (43%) and Germany (7%). These differences may be explained on different levels: antibiotic-prescribing practices for respiratory tract infections; patient-demand factors and health-belief differences; social determinants, including differing child-care practices; and differences in regulatory practices. Understanding these determinants is crucial for the success of possible interventions. Finally, we emphasize the overarching importance of a sociocultural approach to preventing antibiotic resistance in the community.

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Figures

Figure 1
Figure 1
Summary of published aggregate data on the prevalence of pneumococci with intermediate (MIC >0.12 mg/L) and high-level (MIC >2.0 mg/L) resistance (A), and the prevalence of erythromycin-resistant pneumococci (B), France and Germany (,,,–11).
Figure 2
Figure 2
Framework of nonmicrobiologic factors influencing outpatient antibiotic use and prevalence of pneumococcal resistance.
Figure 3
Figure 3
Outpatient antibiotic utilization (18,19), France and Germany, 1985–1997. DDD, daily defined doses.
See this image and copyright information in PMC

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