University of Malta, Msida, Malta.
Mater Dei Hospital, Msida, Malta.
J Antimicrob Chemother. 2019 Nov 1;74(11):3379-3383. doi: 10.1093/jac/dkz312.
Sociocultural factors have been hypothesized as important drivers of inappropriate antibiotic prescribing in European ambulatory care. This study sought to assess whether they can also explain the reported variation in broad-spectrum antibiotic (Br-Ab) use among EU/European Economic Area (EEA) countries.
Correlation and regression analysis were performed, using the bootstrap method, between Br-Ab ratios reported from 28 EU countries by the ECDC, and national Hofstede cultural dimensions and control of corruption (CoC) scores.
Significant bootstrapping correlation coefficients were identified between Br-Ab ratios and the dimension of uncertainty avoidance (UAI) as well as CoC. However, following both bootstrapping multiple regression and generalized linear modelling, only UAI was retained as the sole predictor. A logarithmic model explained 58.6% of the variation in European Br-Ab variability solely using national UAI scores (P < 0.001).
Br-Ab prescribing appears to be driven by the level of UAI within the country. Any interventions aimed at reducing Br-Ab in high-consuming EU/EEA countries need to address this cultural perception to maximize their chances of success.
社会文化因素被认为是欧洲门诊医疗中不合理使用抗生素的重要驱动因素。本研究旨在评估它们是否也可以解释欧盟/欧洲经济区（EEA）国家报告的广谱抗生素（Br-Ab）使用的差异。
使用 ECDC 报告的 28 个欧盟国家的 Br-Ab 比值，与国家 Hofstede 文化维度和腐败控制（CoC）得分进行相关性和回归分析，采用自举法。
Br-Ab 比值与不确定性规避（UAI）维度以及 CoC 之间存在显著的 bootstrap 相关系数。然而，在 bootstrap 多元回归和广义线性模型之后，只有 UAI 被保留为唯一的预测因素。一个对数模型仅使用国家 UAI 得分就解释了欧洲 Br-Ab 变异性的 58.6%（P < 0.001）。
Br-Ab 的处方似乎受到国家内部 UAI 水平的驱动。任何旨在减少高消耗欧盟/EEA 国家 Br-Ab 的干预措施都需要解决这种文化观念，以最大限度地提高其成功的机会。
