Of antibiotics and globalisation

There has been much recent research into the overuse of antibiotics by Europeans. Consumption of these drugs varies strikingly across Europe, with Greeks, the heaviest users, taking three times as many as the Dutch, who use the fewest. Rather like trade protection, the popping of an antibiotic offers false comfort to individuals, says the Economist.

As with political debates over free trade, some people appear to suffer from a corrosive lack of trust when the authorities tell them that they are demanding the wrong thing, says the Economist:

In an anonymous 2008 survey, Greek paediatricians said that 85 per cent of parents demanded antibiotics for children with the common cold virus.

Even when told that antibiotics cannot fight viruses, 65 per cent of Greek parents in the survey insisted they did until their doctors gave in.

Scientists talk of a broad north-south divide in Europe, with the Dutch, Germans, Scandinavians and Baltics consuming few antibiotics, but lots being guzzled in the Mediterranean. The main users are Greece, Cyprus, France and Italy, with Spain almost as high once illicit sales without a prescription are counted. Just as with trade barriers, pill-popping has bad side-effects. For example:

In most north European countries, penicillin can deal with a common nasty, streptococcus pneumonia in all but 5 per cent of cases.

But in high antibiotic consumers like Cyprus, France and Spain, more than a quarter of cases do not respond to penicillin.

Above all, many experts come back to levels of anxiety, and intolerance for uncertainty, as a key driver of antibiotic demand. And this may explain one final correlation. When comparing countries that use the most antibiotics with those most sceptical of the benefits of globalisation four of the top five match.

Yet this correlation also gives grounds for hope, says the Economist. Education and transparency work wonders in reducing antibiotic use. Even though cultural differences cannot be erased altogether, trust can be built.

Source: Editorial, Of antibiotics and globalization, The Economist, January 8, 2009.

For text: http://www.economist.com/world/europe/displaystory.cfm?story_id=12896714

For more on International Issues: http://www.ncpa.org/sub/dpd/index.php?Article_Category=26

FMF Policy Bulletin/ 27 January 2009