Less antibiotics in the East than in the West

Less antibiotics in the East than in the West

09/07/2014

Scientists have for the first time examined the prescribing behavior of physicians for common infectious diseases in a study. It turned out that in the East, the majority of antibiotics were prescribed than in the West. The careless handling of antibiotics has been criticized internationally for years.

More antibiotics in the old states
When patients with cystitis, bronchitis or tonsillitis go to the doctor, it also depends on where they live, whether or not they are prescribed antibiotics. In the West, they might be able to get these drugs sooner than in the East, as research shows. Accordingly, scientists of the supply atlas - an information offer of the central institute for the Kassenärztliche supply in Germany (ZI) - nationwide billing data from the Kassenärztlichen supply from the year 2009 analyzed, in order to analyze the prescription behavior of the physicians with different infections. They came to the conclusion that "with the exception of scarlet fever, fewer antibiotics are prescribed for the infectious diseases examined in the new federal states than in the old federal states".

Significant differences in middle ear infections and urinary tract infections
The data analyzed included diseases such as respiratory tract infection, pharyngitis, tonsillitis, scarlet fever, pneumonia, otitis media and urinary tract infection. The Head of the Supply Atlas, dr. Jörg Bätzing-Feigenbaum explained: „Through this analysis, the Kassenärztliche Vereinigungen and the physicians in the field make an important contribution to the qualitative and quantitative improvement of the antibiotic prescriptions in the outpatient sector.“ East-West differences are most pronounced in middle ear infections (28 percent vs. 38 percent) and urinary tract infections (49 percent vs. 59 percent). In respiratory infections, on average, every third patient in Germany (30.6 percent) receives antibiotics. In the East, at 29 percent, it is slightly less than in the West, at 31 percent. In scarlet fever, there were no differences in the drug prescription.

Prescription rate in pneumonia surprised
In pneumonia, the benefits of antibiotics are undisputed. „High prescription rates would be expected accordingly“ concluded the ZI researchers. Nonetheless, physicians treated only 53.7% of outpatients in the German federal state as antibiotics (East: 48%, West: 55%). „The actual prescription rate is probably much higher“, as the researchers write. Presumably some of those affected were hospitalized in hospital, which is not covered in the report.

Prescription rates generally too high
In addition, as the study indicates, pharyngeal and tonsillitis infections were generally over-prescribed, while for the majority of respiratory infections caused by viruses, clinicians were reluctant to use antibiotics as recommended in the guidelines. In these diseases, antibiotic therapy according to European quality indicators is justified in up to 20 percent of cases. However, in Germany, up to 59.5 percent of cases are treated with antibiotics, and even with middle ear infections the prescription rates would be higher than the quality indicators show.

Consumption of antibiotics is too high worldwide
According to the World Health Organization (WHO), the consumption of antibiotics is generally too high worldwide. That also applies to Germany. However, the Federal Republic of Germany, together with the Netherlands and Estonia belongs to the group with the lowest antibiotic use in Europe: While in this country less than 15 defined daily doses per 1,000 inhabitants are prescribed, the rates are among the front runners between 37 and 43 daily doses. Experts advise again and again to a sparing use of antibiotics. On the one hand, patients should be spared as many side effects as possible and, moreover, there is a risk of increased antibiotic resistance if the medication is not used responsibly.

Thousands killed for antibiotic resistance
According to WHO estimates, "in Europe alone, 25,000 people die every year from antibiotic resistance". There are no data available on the global scale because "many countries do not take the health threat of resistant bacteria seriously and therefore do not collect data". If drugs are no longer effective, there is a risk that blood poisoning, pneumonia, venereal diseases such as gonorrhea or diarrheal diseases will be as life-threatening as before the invention of penicillin. (Ad)