Socioeconomic inequalities in the self-reported use of antibiotics in the European Union, 2009-2022: a repeated cross-sectional analysis.

Abstract

This study aims to explore trends in the use of antibiotics, in the context of the COVID-19 pandemic, across the European Union (EU), focusing on socioeconomic inequalities. Repeated cross-sectional analysis. 26 EU member states. Analyses were conducted using data from five waves of the Eurobarometer survey (2009-2022, n=1 27 299). We used multilevel logistic regression, stratified by financial difficulty, to examine changes in the past-year use of antibiotics and in obtaining antibiotics inappropriately over time, adjusting for gender, age, type of community, children under 10 years in the household and antibiotic-related knowledge. We found that the odds of self-reported use of antibiotics decreased between 2009 and 2022 in those with (OR=0.59, 95% CI 0.55-0.63) and without financial difficulties (OR=0.53, 95% CI 0.50 to 0.56), with a substantial reduction between 2018 and 2022. However, a relatively higher proportion of Europeans who used antibiotics in the past year were obtaining them inappropriately in those with (OR=2.03, 95% CI 1.68 to 2.45) and without financial difficulties (OR=1.83, 95% CI 1.53 to 2.19) in 2022. Among those with financial difficulties, higher self-reported use of antibiotics and inappropriately obtaining antibiotics were associated with lesser knowledge about antibiotics. Despite notable progress made in the EU in reducing antibiotic use, current efforts fall short in addressing the issue of inappropriate antibiotic use. A targeted approach prioritising outreach to vulnerable populations to advance attitudes and behaviours related to appropriate antibiotic use may be required to achieve further progress.