Abstract
OBJECTIVES: This study aims to explore trends in the use of antibiotics, in the context of the COVID-19 pandemic, across the European Union (EU), focusing on socioeconomic inequalities. DESIGN: Repeated cross-sectional analysis. SETTING: 26 EU member states. PARTICIPANTS: Analyses were conducted using data from five waves of the Eurobarometer survey (2009-2022, n=1 27 299). PRIMARY AND SECONDARY OUTCOME MEASURES: We used multilevel logistic regression, stratified by financial difficulty, to examine changes in the past-year use of antibiotics and in obtaining antibiotics inappropriately over time, adjusting for gender, age, type of community, children under 10 years in the household and antibiotic-related knowledge. RESULTS: We found that the odds of self-reported use of antibiotics decreased between 2009 and 2022 in those with (OR=0.59, 95% CI 0.55-0.63) and without financial difficulties (OR=0.53, 95% CI 0.50 to 0.56), with a substantial reduction between 2018 and 2022. However, a relatively higher proportion of Europeans who used antibiotics in the past year were obtaining them inappropriately in those with (OR=2.03, 95% CI 1.68 to 2.45) and without financial difficulties (OR=1.83, 95% CI 1.53 to 2.19) in 2022. Among those with financial difficulties, higher self-reported use of antibiotics and inappropriately obtaining antibiotics were associated with lesser knowledge about antibiotics. CONCLUSION: Despite notable progress made in the EU in reducing antibiotic use, current efforts fall short in addressing the issue of inappropriate antibiotic use. A targeted approach prioritising outreach to vulnerable populations to advance attitudes and behaviours related to appropriate antibiotic use may be required to achieve further progress.