title: Corruption and use of antibiotics in regions of Europe.
abstract: The aim of this article is to investigate the association between corruption and antibiotic use at sub-national level. We explore the correlation between, on the one hand, two measures of corruption (prevalence of corruption in the health sector and prevalence of bribes in the society) at regional level from the European Quality of Government Index; and, on the other, the consumption of antibiotics in those European regions from a 2009 Special Euro Barometer. In a multivariate regression model, we control for potential confounders: purchasing power of standardized regional gross domestic product, inhabitants per medical doctor and age-standardized all-cause mortality rates. We find that there is a strong positive association between both measures of corruption (i.e. in the health sector, and in the society at large) and antibiotics use; and that this association is robust to the introduction of the control variables. These results support previous findings in the literature linking corruption to higher antibiotic use at cross-national level. We show that corruption does seem to account for some of the remarkable between-region variation in antibiotic consumption in Europe.
authors.affiliation: Department of Political Science, University of Gothenburg, Box 700, SE 40530, Gothenburg, Sweden; Centre for Collective Action Research, University of Gothenburg, Sweden; Centre for Antibiotic Resistance Reserach, University of Gothenburg, Sweden. Electronic address: bjorn.ronnerstrand@pol.gu.se.
authors.forename: Björn
authors.initials: B
authors.lastname: Rönnerstrand
authors.affiliation: Quality of Government Institute, Department of Political Science, University of Gothenburg, Box 700, SE 40530, Gothenburg, Sweden. Electronic address: victor.lapuente@pol.gu.se.
authors.forename: Victor
authors.initials: V
authors.lastname: Lapuente
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D005060:Europe; D005607:Fraud; D033161:Government Regulation; D019981:Health Care Sector; D006801:Humans; D008954:Models, Biological; D055553:Prescription Drugs / Q000600:supply & distribution; D015995:Prevalence; D012959:Socioeconomic Factors
chemical_list: D000900:Anti-Bacterial Agents; D055553:Prescription Drugs
keywords: Antibiotic use; Bribery; Corruption; Europe; Regions