Cross-border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany.
BACKGROUND
Antibiotic resistance is a worldwide problem and inappropriate prescriptions are a cause. Especially among children, prescriptions tend to be high. It is unclear how they differ in bordering regions. This study therefore examined the antibiotic prescription prevalence among children in primary care between northern Netherlands and north-west of Germany.


METHODS
Two datasets were used: The Dutch (IADB) comprises representative data of pharmacists in North Netherland and the German (BARMER GEK) includes nationwide health insurance data. Both were filtered using postal codes to define two comparable bordering regions with patients under 18 years for 2010.


RESULTS
The proportion of primary care patients receiving at least one antibiotic was lower in northern Netherlands (29.8 %; 95 % confidence interval [95 % CI]: 29.3-30.3), compared to north-west Germany (38.9 %; 95 % CI: 38.2-39.6). Within the respective countries, there were variations ranging from 27.0 to 44.1 % between different areas. Most profound was the difference in second-generation cephalosporins: for German children 25 % of the total prescriptions, while for Dutch children it was less than 0.1 %.


CONCLUSIONS
This study is the first to compare outpatient antibiotic prescriptions among children in primary care practices in bordering regions of two countries. Large differences were seen within and between the countries, with overall higher prescription prevalence in Germany. Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach.
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Jan-Willem H
JW
Dik
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Bhanu
B
Sinha
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Alex W
AW
Friedrich
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Jerome R
JR
Lo-Ten-Foe
Certe Laboratories for Infectious Diseases, Groningen, The Netherlands.
Ron
R
Hendrix
Institute for Hospital Hygiene, University Medical Campus Oldenburg, Oldenburg, Germany ; Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Robin
R
Köck
IADB, Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics, University of Groningen, Groningen, The Netherlands.
Bert
B
Bijker
IADB, Department of Pharmacy, Unit of PharmacoEpidemiology & PharmacoEconomics, University of Groningen, Groningen, The Netherlands ; Institute of Science in Healthy Aging & healthcaRE (SHARE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Maarten J
MJ
Postma
Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Michael H
MH
Freitag
Centre for Social Policy Research, Division Health Economics, Health Policy and Outcomes Research, University of Bremen, Bremen, Germany.
Gerd
G
Glaeske
Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Falk
F
Hoffmann
Antibiotics; Border research; Germany; Health services research; Netherlands