title: Use of antibiotics in rural and urban regions in The Netherlands: an observational drug utilization study.
abstract: BACKGROUND
  Large livestock farms might increase the infection risk for the nearby human population because of an increased risk for disease outbreaks and because antibiotic-resistant bacteria are more likely to be present. We hypothesized that populations residing in rural areas have more contact with cattle compared with populations in urban areas, and will use more antibiotics or more frequently require a new course of antibiotics.
  
  
  METHODS
  Using data from the prescription database IADB.nl, we compared antibiotic use by patients living in rural areas to the use by patients living in urban areas. We also followed cohorts of antibiotic users and determined the patients who required a second antibiotic within 14 days after beginning the first antibiotic.
  
  
  RESULTS
  The yearly prevalence of antibiotic use was greater in rural areas compared with urban areas (2009: 23.6% versus 20.2% (p < 0.001), especially in the younger age groups. More adult patients residing in rural areas required a second course of antibiotic treatment within 14 days after starting the first treatment.
  
  
  CONCLUSIONS
  Individuals use more antibiotics, and adults more frequently require a second antibiotic prescription within 14 days, in rural areas compared with urban areas. Although the differences were small and the risks for the general rural population were not high, this difference should be investigated further.
authors.affiliation: Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, A, Deusinglaan 1, 9713AV Groningen, the Netherlands. josta.de.jong@rug.nl.
authors.forename: Josta
authors.initials: J
authors.lastname: de Jong
authors.forename: Jens H J
authors.initials: JH
authors.lastname: Bos
authors.forename: Tjalling W
authors.initials: TW
authors.lastname: de Vries
authors.forename: Lolkje T W
authors.initials: LT
authors.lastname: de Jong-van den Berg
mesh_terms: D000293:Adolescent; D000328:Adult; 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*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015995:Prevalence; D019035:Rural Health Services; D019037:Urban Health Services; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents