Cross border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany

J.W. Dik, F. Hoffmann, JR Lo Ten Foe, B. Bijker, David Saß, MJ Postma, R. Hendrix, B. Sinha, G Glaeske, AW Friedrich

Research output: Contribution to conferencePosterAcademic


Antimicrobial resistance is becoming a growing threat to public health worldwide. Inappropriate prescriptions and use of antibiotics are known to contribute to the problem. Within Europe there are wide variations in antibiotic use. Especially with paediatric patients, prevalence is known to be greater. This study set out to examine the prevalence and most frequent prescribed types between out-patient children and adolescents from two bordering regions of Germany and the Netherlands.

We performed a cross-sectional study comparing antibiotic prescriptions in the Northern Netherlands (postal codes 9xxx, Groningen/Drenthe) and North-West Germany (postal codes 26xxx; Niedersachsen). Both regions have about 1 million inhabitants and border on each other (Figure 1). Data comprises 2010 and focused on ages 0-17 years. Antibiotics were selected based on the Anatomical Therapeutic Chemical (ATC) code J01 in the outpatient setting.

Dutch data were derived from pharmacy dispensing data of the InterAction Database ( The IADB comprises all prescriptions from approximately 470,000 persons in north-eastern Netherlands (of them about 263,000 in postal codes 9xxx).

German data were derived from claims data of a large statutory health insurance fund, the BARMER GEK, representing approximately 8.4 million persons nationwide (of them about 104,000 in postal codes 26xxx).

The proportion of children and adolescents receiving at least one antibiotic course was higher in North-West Germany (38.9%) compared to the Northern Netherlands (29.8%). There were regional variations ranging between 27.0-36.4% in the Northern Netherlands and 35.1- 44.1% in North-West Germany. The proportion with prescriptions was highest in children aged 0-2 years (Northern Netherlands vs. North-West Germany: 43.1% vs. 49.9%) and those aged 3-6 years (37.4% vs. 54.8%).

Distribution of substances varied between the two regions. Amoxicillin was the most prescribed substance in both regions, 49.6% of all prescriptions in the Netherlands versus 21.1% in Germany. Most profound difference was second generation cephalosporins which comprised 25% of the prescriptions in Germany and less than 0.1% in the Netherlands.
Original languageEnglish
Publication statusPublished - 26-Apr-2015
Event25th European Congress of Clinical Microbiology and Infectious Diseases - Copenhagen, Denmark
Duration: 25-Apr-201528-Apr-2015
Conference number: 25


Conference25th European Congress of Clinical Microbiology and Infectious Diseases
Internet address


  • Germany and the Netherlands
  • paediatric therapy

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