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National antibiotic resistance linked to severity of government corruption
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Increased antimicrobial resistance may be heavily associated with the extent of corruption within a country’s government, according to recent data published in PLOS ONE.
“We found poor governance and higher levels of corruption are associated with higher levels of antibiotic resistance,” Peter Collignon, MD, of the Australian National University School of Medicine, said in a press release. “It is a finding that will be surprising to most people in the field of medicine.”
Collignon and colleagues developed a multivariate analysis model using data from 28 European countries collected between 1998 and 2010. A country’s antibiotic usage and quality of governance were the primary explanatory variables used to influence overall antibiotic resistance, with economic advancement, quality of governance, private health care expenditure and tertiary education acting as control variables. Real-value data on antimicrobial resistance was obtained from the EARS-Net Database of the European Centre for Disease Prevention and Control.
The researchers found that factors other than antibiotic usage had an impact on antimicrobial resistance. A simple model attributed 28% of resistance variation to antibiotic usage, which increased to 33% with the introduction of time effects to explain global trends. Including the variable for corruption resulted in 63% of antibiotic resistance explained by the regression model. Introducing all other control variables only increased the model’s accuracy by 7%, indicating that corruption was the main socioeconomic factor with an influence on a country’s overall antibiotic resistance. A country’s income level showed no effect.
“We postulate that when quality of governance is poor, then there are likely to be less effective controls of antibiotic use (not only in people but in the animal sector),” the researchers wrote. “Thus, not only will more antibiotic resistant bacteria develop but the spread of these resistant bacteria will also be easier.
“Reducing antimicrobial resistance requires a policy mix aimed at lowering antibiotic usage in people and, perhaps even more importantly, developing better controls on corruption.”
Disclosure: The researchers report no relevant financial disclosures.
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