title: Too much and too little? Prevalence and extent of antibiotic use in a New Zealand region.
abstract: OBJECTIVE
  Although antibiotic use in the community is a significant contributor to resistance, little is known about social patterns of use. This study aimed to explore the use of antibiotics by age, gender, ethnicity, socio-economic status and rurality.
  
  
  METHODS
  Data were obtained on all medicines dispensed to ambulatory patients in one isolated town for a year, and data on antibiotics are presented in this paper. Demographic details were obtained from pharmacy records or by matching to a national patient dataset.
  
  
  RESULTS
  During the study year, 51% of the population received a prescription for one or more antibiotics, and on average people in the region received 10.15 defined daily doses (DDDs). Prevalence of use was higher for females (ratio, 1.18), and for young people (under 25) and the elderly (75 and over), and the amount in DDDs/person/year broadly followed this pattern. Māori (indigenous New Zealanders) were less likely to receive a prescription (48% of the population) than non-Māori (55%) and received smaller quantities on average. Rural Māori, including rural Māori children, received few prescriptions and low quantities of antibiotics compared with other population groups.
  
  
  CONCLUSIONS
  The level of antibiotic use in the general population is high, despite campaigns to try to reduce unnecessary use. The prevalence of acute rheumatic fever is high amongst rural Māori, and consequently treatment guidelines recommend prophylactic use of antibiotics for sore throat in this population. This makes the comparatively very low level of use of antibiotics amongst rural Māori children very concerning.
authors.affiliation: School of Pharmacy, University of Otago, Box 56, Dunedin 9054, New Zealand. pauline.norris@otago.ac.nz
authors.forename: Pauline
authors.initials: P
authors.lastname: Norris
authors.forename: Simon
authors.initials: S
authors.lastname: Horsburgh
authors.forename: Shirley
authors.initials: S
authors.lastname: Keown
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
authors.forename: Kirsten
authors.initials: K
authors.lastname: Lovelock
authors.forename: Jackie
authors.initials: J
authors.lastname: Cumming
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.forename: Peter
authors.initials: P
authors.lastname: Crampton
authors.forename: Gordon
authors.initials: G
authors.lastname: Becket
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents