School of Public Health, Boston University, Boston, MA, USA.
Public Health Foundation of India, New Delhi, Delhi, India.
Sci Rep. 2024 Feb 29;14(1):5052. doi: 10.1038/s41598-024-54250-2.
The consumption of antibiotics varies between and within countries. However, our understanding of the key drivers of antibiotic consumption is largely limited to observational studies. Using Indian data that showed substantial differences between states and changes over years, we conducted a quasi-experimental fixed-effects regression study to examine the determinants of private-sector antibiotic consumption. Antibiotic consumption decreased by 10.2 antibiotic doses per 1000 persons per year for every ₹1000 (US$12.9) increase in per-capita gross domestic product. Antibiotic consumption decreased by 46.4 doses per 1000 population per year for every 1% increase in girls' enrollment rate in tertiary education. The biggest determinant of private sector antibiotic use was government spending on health-antibiotic use decreased by 461.4 doses per 1000 population per year for every US$12.9 increase in per-capita government health spending. Economic progress, social progress, and increased public investment in health can reduce private-sector antibiotic use.
抗生素的消费在国家之间和国家内部存在差异。然而，我们对抗生素消费的主要驱动因素的理解在很大程度上仅限于观察性研究。利用印度的数据，这些数据显示了各州之间的巨大差异和多年来的变化，我们进行了一项准实验固定效应回归研究，以研究私营部门抗生素消费的决定因素。人均国内生产总值每增加 1000 卢比（12.9 美元），抗生素消费就会减少 10.2 个抗生素剂量/每 1000 人/年。每增加 1%的高等教育女生入学率，抗生素消费就会减少 46.4 个剂量/每 1000 人/年。私人部门抗生素使用的最大决定因素是政府对卫生的支出-人均政府卫生支出每增加 12.9 美元，抗生素消费就会减少 461.4 个剂量/每 1000 人/年。经济进步、社会进步和增加公共卫生投资可以减少私营部门的抗生素使用。
