Programme no. 341-OP
Public Health
Investigating cultural determinants for antibiotic prescribing and consumption in Europe
Siri Jensen*1, Maciek Godycki-Cwirko2, Pia Toboul-Lundgren 3
1Department of General Practice,University of Oslo,Oslo,Norway, 2department of Family and Community Medicine,University of Lodz,Lodz,Poland, 3Département de Santé Publique ,Hôpital de l'Archet 1,Nice,France
* = Presenting author
Objectives: To identify cultural determinants for patient preconceptions and expectations of respiratory tract infections and antibiotic treatment and health seeking behaviour.
Background: Antibiotic resistance is a growing problem worldwide. Research shows a clear connection between a high consumption of antibiotics and the development of resistance. There are great variations between the European countries when it comes to consumption. In spite of several interventions, the variations seem to be constant. Cultural differences are often cited as an explanation for these variations.

In Norway 60 % of all antibiotics prescribed in Primary Care are prescribed for Respiratory Tract Infections (RTI’s). Many of these are unnecessary because most RTI’s are due to viruses which cannot be treated with antibiotics. Several studies show that the labeling of illness is an important factor when it comes to seeing the GP and asking for antibiotics. In a study by Deschepper et al [i]on Cross-cultural differences in lay attitudes and utilization of antibiotics in a Belgian and Dutch city, Dutch participants labelled most URTD episodes as 'common cold' or 'flu'. The Flemish participants labelled most of their URTD episodes as 'bronchitis' and used more antibiotics.

Certain symptoms are also a contributing factor for seeing the GP, together with the length of the symptom.. Having a cough is one of those symptoms. While patients in some countries see their doctor after three days of coughing, patients in other countries waits for twelve days.[ii]


Results: Preliminary results will be presented.
Material/Methods: Semi structured in-depth interviews with adult patients in Norway, France and Poland seeing their GP with a respiratory tract infection. The patients are interviewed before and after consultation. The interviews are recorded. Each country will conduct the interviews in their own language. The interviews will be transcribed and later translated into English before analysis. In order to secure the translation back translation will also be carried out.
Conclusion: Hopefully we will be able to identify certain cultural determinants for antibiotic prescribing and consumption.

Points for discussion: Are there any cultural determinants that are more dominant in the Nordic countries than in the European?

Is it possible to change people’s attitude towards the use of antibiotics, and if so, how?