Study to analyze regional differences in antibiotic prescriptions


Antibiotics are indispensable for the treatment of a large number of bacterial infections and are among the most frequently prescribed drugs in Germany. The vast majority of prescriptions occur in the outpatient field. Although overall antibiotic consumption in Germany is not as high as in other European countries, there are comparatively high prescription rates for individual antibiotic groups. In Germany, there are noticeable differences in prescriptions with regard to regional variations and between age groups. For example, in Schleswig-Holstein, in the federal states in Eastern Germany as well as in Berlin and Bavaria, the number of prescriptions is generally lower than in Rhineland-Palatinate or Saarland. Furthermore, there is regional variation in prescription patterns depending on the age group. For children below the age of 15 years, for example, the prevalence of prescriptions is in some cases higher in the east than in the west.

The increase and spread of resistant pathogens compromise the effectiveness of antibiotics and thus the medical care of the population. In 2008, the German government launched various measures, including the German Antibiotics Resistance Strategy “DART 2020” developed by the Federal Ministries of Health, Food and Agriculture as well as Education and Research. DART 2020 was adopted by the Federal Cabinet in May 2015. The problem of resistance is also the subject of the “pharmaceutical dialogue”, in which representatives of pharmaceutical manufacturers, the scientific community, and the trade union “IG BCE” collaborate in the cross-departmental development of agreements to strengthen Germany as a research and manufacturing hub. With regard to antibiotics, the partners agreed, among other things, to strengthen healthcare research in the field of antibiotics through a study commissioned by the Federal Ministry of Health. The study will investigate the background and causes of differences in antibiotic prescriptions between regions and between different age groups. In addition, possible changes over time will be investigated by comparing the results with already published results of other studies conducted on the basis of data through 2014.

In a first step, this study aims to describe the regional differences and the differences between the age groups in antibiotic prescriptions in Germany on the basis of current data starting with 2015, to carry out a descriptive analysis of the chronological sequence of antibiotic prescriptions, and to compare the results with already published findings for 2008–2014 using data from the German Pharmacoepidemiological Research Database (GePaRD).

In a second step, the reasons for the identified differences in prescription prevalence of antibiotics will be evaluated. This will be realized in two sub-studies. Based on GePaRD data, potential explanations will be determined by means of multivariable regressions (Sub-study 1). In addition, a qualitative study will be carried out to record and classify subjective influences on individual prescription behavior (Sub-study 2).

Based on the results of this study, measures for the promotion of appropriate use of antibiotics will be developed.

Funding period

Begin:   April 2019
End:   March 2022


  • Federal Ministry of Health


Dr. rer. nat. Oliver Scholle


  • Prof. Benjamin Schüz (Institut für Public Health und Pflegeforschung, Universität Bremen)