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Antibiotic use and its impact on antibiotic resistance: A comparative study between Sweden and the US focusing on acute otitis media and acute pyelonephritis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2016 (English)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Introduction: This project is an analysis of the causes and effects of antibiotic resistance bacteria in contemporary society, since antibiotic resistance is one of the biggest health threats in the world today. The regulations and perceptions of antibiotics are compared between the US and Sweden.

Purpose: The purpose of this project is to compare the sales of penicillin-V and amoxicillin for acute otitis media and ciprofloxacin for acute pyelonephritis in Sweden with the sales in the US. An analysis of literature is made to see whether differences in the sales rate in either of these countries has to do with the higher antibiotic resistance in the US, or if this is due to other factors.

Materials and methods: This project is based on literature reviews in conjunction with (1) a control variable: similar treatment guidelines in Sweden and the US, (2) a dependent variable: antibiotic resistant strains present in Sweden and the US, and (3) an independent variable: sales rate/usage of narrow-spectrum penicillins, amoxicillin, and ciprofloxacin in Sweden and the US. 

Results: The US data show a high use of amoxicillin and ciprofloxacin, while Swedish data show higher usage of more narrow-spectrum antibiotics. Many US farmers add antibiotics to their livestock for prevention of illness or growth of bigger animals, which is likely to increase the rate of antibiotic resistant bacteria. In Sweden it is illegal to add antibiotics in livestock feed for these purposes.

Conclusions: Higher sales rates of amoxicillin and ciprofloxacin (with generalizations made) in the US compared to Sweden are likely connected to the higher antibiotic resistance in the US. Broad-spectrum antibiotics may increase antibiotic resistance more than a use of narrow-spectrum antibiotics; the Swedish data show a higher sales rate of narrow-spectrum penicillins and a lower rate of antibiotic resistant bacteria, which may strengthen this statement. Other factors such as antibiotics used in livestock and over the counter antibiotics are also likely contributors to an increased antibiotic resistance.

Place, publisher, year, edition, pages
2016. , 26 p.
Keyword [en]
antibiotic, antibiotic resistance, antibiotic resistant bacteria, acute pyelonephritis, acute otitis media, bacterial infection, upper urinary tract infection, ear infection, antibiotic use, UTI, ciprofloxacin, amoxicillin, penicillin, narrow spectrum, broad spectrum
Keyword [sv]
antibiotika, antibiotikaresistens, antibiotikaresistenta bakterier, akut pyelonefrit, akut mediaotit, bakteriell infektion, övre urinvägsinfektion, öroninflammation, UVI, antibiotikaanvändning, ciprofloxacin, amoxicillin, penicillin, bredspektrum, smalspektrum
National Category
Basic Medicine
URN: urn:nbn:se:uu:diva-296383OAI: oai:DiVA.org:uu-296383DiVA: diva2:937785
Subject / course
Educational program
Bachelor of Science Programme in Pharmacy
Available from: 2016-06-16 Created: 2016-06-15 Last updated: 2016-06-16Bibliographically approved

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