INTRAURBAN VARIATION OF ANTIBIOTIC UTILIZATION IN CHILDREN - INFLUENCE OF SOCIOECONOMIC-FACTORS

Objective: The aim of this study was to investigate the intra-urban va riation of antibiotic utilization in children in Malmo and to evaluate the influence of socio-economic factors on this variation. Methods: I n atl ecological analysis, the variations in antibiotic utilization in children, expressed as defined daily dose (DDD) or as the number of p rescriptions per 1000 inhabitants per day, were compared with variatio ns in socio-economic and demographic factors in the 17 administrative districts of the Swedish city of Malmo (235 000 inhabitants). Results: There were large between-area differences in antibiotic utilization, especially in children aged 0-6 years. Socio-economic factors reflecti ng a privileged situation correlated positively with antibiotic utiliz ation. Thus, in districts with a high median family income and a high employment rate, the utilization of antibiotics was higher than in oth er districts. Conversely, in districts with a high proportion of blue- collar workers, people with foreign backgrounds and recipients of soci al benefit, antibiotic utilization was comparatively low. In contrast, the utilization of penicillin V relative to other antibiotics showed an opposite pattern, including positive correlations with the proporti on of social benefit, immigrants and blue-collar workers and a negativ e correlation with employment rate. Conversely the utilization of macr olides in relation to other antibiotics in children aged 0-6 years was highest in districts inhabited by those who were socio-economically p rivileged. Interpretation: The findings suggest that utilization of an tibiotics in children may vary considerably within a city, that it may increase with the degree of parental affluence, and that such affluen ce may reduce the utilization of penicillin V relative to other antibi otics.