Cultural and Socioeconomic Determinants of Antibiotic Use

Harbarth, Stéphan Juergen; Monnet, Dominique

doi:10.1007/978-0-387-70841-6_3

Cited by 39 publications

(29 citation statements)

References 38 publications

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“…7 This has been ascribed to be linked to national cultural differences. 8,9 Hofstede's model of cultural dimensions is one of the most accepted approaches for analysis of cultural differences between countries, with more than 800 citations in peerreviewed journals. It defines culture as the collective programming of the mind that distinguishes the members of one group or category of people from another.…”

Section: Introductionmentioning

confidence: 99%

Understanding the epidemiology of MRSA in Europe: do we need to think outside the box?

Borg

Camilleri

Waisfisz³

2012

Journal of Hospital Infection

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Background: The epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) infections, using bacteraemia as a marker, shows a striking geographical pattern in Europe. The prevalence of MRSA is low in Northern European countries, increases into central Europe and reaches its highest levels in the Mediterranean region. This has been attributed to varying levels of implementation of infection control and antibiotic stewardship (ICAS) programmes, but reasons for this variation have not been clearly established. Aim: To investigate the possible impact of national cultural dimensions on the epidemiology of MRSA in Europe. Methods: Median proportions of MRSA bacteraemia were sourced for countries participating in the EARS-Net surveillance network in 2010, and correlated with the national cultural dimension scores of Hofstede et al. Findings: Significant associations were identified between MRSA proportions and the cultural constructs of uncertainty avoidance (UAI), masculinity (MAS) and power distance. Multiple regression models found significant associations for UAI, MAS and short-term orientation (R 2 adjusted ¼ 0.475; P < 0.001). The model was found to be predictive of MRSA trends identified in several European countries between 2006 and 2010. Conclusion: Implementation of ICAS programmes often requires behavioural change. Cultural dimensions appear to be key factors affecting perceptions and values among healthcare workers, which in turn are critical for compliance and uptake. Customizing ICAS initiatives to reflect the local cultural background may improve their chances of success.

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Section: Introductionmentioning

confidence: 99%

Understanding the epidemiology of MRSA in Europe: do we need to think outside the box?

Borg

Camilleri

Waisfisz³

2012

Journal of Hospital Infection

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“…Based on these hypotheses, it has been suggested that Power Distance and Uncertainty Avoidance were correlated with antibiotic consumption [ 16 , 17 ]. However, cultural aspects linked to the suboptimal use of antibiotics remained a point of particular interest calling for a better understanding [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe?

Deschepper

Grigoryan

Lundborg

et al. 2008

BMC Health Serv Res

175

168

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Background: Antibiotics are widely-used medicines for which a more prudent use has been advocated to minimize development of resistance. There are considerable cross-national differences that can only partially be explained by epidemiological difference and variations in health care structure. The aim of this study was to explore whether cross-national differences in use of antibiotics (prescribed and non-prescribed) are associated with differences between national cultures as described in Hofstede's model of cultural dimensions (Power Distance, Individualism, Masculinity, Uncertainty Avoidance and Long-Term Orientation).

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“…For example, in a study by Bjerrum et al [10] it was discovered that national differences in prescription rates do not tend to mirror the prevalence of bacterial infections, but are related to national recommendations, treatment traditions and pharmaceutical marketing. Other contextual factors found to be important in the previous literature are type of health-care system [9], corruption [11,12] and a number of cultural factors [13,14], for example, risk aversion [15,16].…”

Section: Previous Researchmentioning

confidence: 99%