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Assessing the impact of national antibiotic campaigns in Europe


  • M. Filippini
  • L. Ortiz
  • G. Masiero



Because of evidence of causal association between antibiotic use and bacterial resistance, the implementation of national policies has emerged as a interesting tool for controlling and reversing bacterial resistance. The aim of this study was to assess the impact of public policies on antibiotic use in Europe using a differences-in-differences approach. Comparable data on systemic antibiotics administered in 21 European countries are available for a 11-year period between 1997 and 2007. Data on national campaigns are drawn from the public health literature. We estimate an econometric model of antibiotic consumption with country fixed effects and control for the main socioeconomic and epidemiological factors. Lagged values and the instrumental variables approach are applied to address endogeneity aspects of the prevalence of infections and the adoption of national campaigns. We find evidence that public campaigns significantly reduce the use of antimicrobials in the community by 1.3–5.6 defined daily doses per 1,000 inhabitants yearly. This represents an impact of roughly 6.5–28.3 % on the mean level of antibiotic use in Europe between 1997 and 2007. The effect is robust across different measurement methods. Further research is needed to investigate the effectiveness of policy interventions targeting different social groups such as general practitioners or patients. Copyright Springer-Verlag 2013

Suggested Citation

  • M. Filippini & L. Ortiz & G. Masiero, 2013. "Assessing the impact of national antibiotic campaigns in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 587-599, August.
  • Handle: RePEc:spr:eujhec:v:14:y:2013:i:4:p:587-599
    DOI: 10.1007/s10198-012-0404-9

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    References listed on IDEAS

    1. Gabor Kezdi, 2005. "Robus Standard Error Estimation in Fixed-Effects Panel Models," Econometrics 0508018, EconWPA.
    2. Giavazzi, Francesco & Tabellini, Guido, 2005. "Economic and political liberalizations," Journal of Monetary Economics, Elsevier, vol. 52(7), pages 1297-1330, October.
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    Cited by:

    1. Blázquez-Fernández, Carla & González-Prieto, Noelia & Moreno-Mencía, Patricia, 2013. "Pharmaceutical Expenditure as a Determinant of Health Outcomes in EU Countries/El gasto farmacéutico como determinante de los resultados en salud en países de la UE," Estudios de Economía Aplicada, Estudios de Economía Aplicada, vol. 31, pages 379-396, Septiembr.
    2. Eibich, Peter & Ziebarth, Nicolas, 2014. "Examining the Structure of Spatial Health Effects in Germany Using Hierarchical Bayes Models," EconStor Open Access Articles, ZBW - German National Library of Economics, pages 305-320.
    3. Mueller, Tanja & Östergren, Per-Olof, 2016. "The correlation between regulatory conditions and antibiotic consumption within the WHO European Region," Health Policy, Elsevier, vol. 120(8), pages 882-889.
    4. Filippini, M. & Heimsch, F. & Masiero, G., 2014. "Antibiotic consumption and the role of dispensing physicians," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 242-251.

    More about this item


    Antibiotic use; Public policies; National campaigns; Difference-in-difference; I18; C21; C54;

    JEL classification:

    • B50 - Schools of Economic Thought and Methodology - - Current Heterodox Approaches - - - General
    • E12 - Macroeconomics and Monetary Economics - - General Aggregative Models - - - Keynes; Keynesian; Post-Keynesian
    • E32 - Macroeconomics and Monetary Economics - - Prices, Business Fluctuations, and Cycles - - - Business Fluctuations; Cycles
    • E44 - Macroeconomics and Monetary Economics - - Money and Interest Rates - - - Financial Markets and the Macroeconomy


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