1Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
2Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.
Antimicrob Resist Infect Control. 2019 Dec 6;8:200. doi: 10.1186/s13756-019-0636-x. eCollection 2019.
The increase of antimicrobial resistance, mainly due to increased antibiotic use, is worrying. Preliminary evidence suggests that antibiotic use differs across ethnic groups in the Netherlands, with higher use in people of non-Dutch origin. We aimed to determine whether appropriate knowledge and use of antibiotics differ by ethnicity and whether knowledge on antibiotics is associated with antibiotic use.
We performed a cross-sectional study analyzing baseline data (2011-2015) from a population-based cohort (HELIUS study), which were linked to data from a health insurance register. We included 21,617 HELIUS participants of South-Asian Surinamese, African-Surinamese, Turkish, Moroccan, Ghanaian, and Dutch origin. Fifteen thousand seven participants had available prescription data from the Achmea Health Data-base (AHD) in the year prior to their HELIUS study visit. Participants were asked five questions on antibiotic treatment during influenza-like illness, pneumonia, fever, sore throat and bronchitis, from which higher versus lower antibiotic knowledge level was determined. Number of antibiotic prescriptions in the year prior to the HELIUS study visit was used to determine antibiotic use.
The percentage of individuals with a higher level of antibiotic knowledge was lower among all ethnic minority groups (range 57 to 70%) compared to Dutch (80%). After correcting for baseline characteristics, including medical conditions, first-generation African Surinamese and Turkish migrants received a significantly lower number of antibiotic prescriptions compared to individuals of Dutch origin. Only second-generation Ghanaian participants received more prescriptions compared to Dutch participants (aIRR 2.09, 95%CI 1.06 to 4.12). Higher level of antibiotic knowledge was not significantly associated with the number of prescriptions (IRR 0.92, 95%CI 0.85 to 1.00).
Levels of antibiotic knowledge varied between ethnic groups, but a lower level of antibiotic knowledge did not correspond with a higher number of antibiotic prescriptions.
抗菌药物耐药性的增加主要是由于抗生素使用的增加，这令人担忧。初步证据表明，荷兰不同族裔群体的抗生素使用情况存在差异，非荷兰裔人群的使用量更高。我们旨在确定抗生素的使用是否因族裔而异，以及抗生素知识是否与抗生素的使用有关。
我们进行了一项横断面研究，分析了基于人群的队列（HELIUS 研究）的基线数据（2011-2015 年），并将这些数据与健康保险登记处的数据进行了关联。我们纳入了 21617 名 HELIUS 参与者，他们分别来自南亚苏里南人、非洲苏里南人、土耳其人、摩洛哥人、加纳人和荷兰人。其中 15077 人在 HELIUS 研究访问前一年有 Achmea 健康数据库（AHD）的处方数据。参与者被问及在流感样疾病、肺炎、发热、喉咙痛和支气管炎期间接受抗生素治疗的五个问题，根据这些问题确定了更高或更低的抗生素知识水平。在 HELIUS 研究访问前一年中使用的抗生素处方数量来确定抗生素的使用情况。
与荷兰人（80%）相比，所有少数民族群体（范围为 57%至 70%）中具有更高抗生素知识水平的个体比例较低。在纠正了包括医疗状况在内的基线特征后，第一代非洲苏里南和土耳其移民接受的抗生素处方数量明显低于荷兰人。只有第二代加纳参与者接受的处方数量多于荷兰参与者（调整后的相对风险比 2.09，95%置信区间 1.06 至 4.12）。更高水平的抗生素知识与处方数量没有显著相关（相对风险比 0.92，95%置信区间 0.85 至 1.00）。
不同族裔群体的抗生素知识水平存在差异，但较低的抗生素知识水平并不对应较高的抗生素处方数量。
