Data from: Socioeconomic determinants of antibiotic consumption in the state of São Paulo, Brazil: the effect of restricting over-the-counter sales

Background: Improper antibiotic use is one of the main drivers of
bacterial resistance to antibiotics, increasing infectious diseases
morbidity and mortality and raising costs of healthcare. The level of
antibiotic consumption has been shown to vary according to socioeconomic
determinants (SED) such as income and access to education. In many Latin
American countries, antibiotics could be easily purchased without a
medical prescription in private pharmacies before enforcement of
restrictions on over-the-counter (OTC) sales in recent years. Brazil
issued a law abolishing OTC sales in October 2010. This study seeks to
find SED of antibiotic consumption in the Brazilian state of São Paulo
(SSP) and to estimate the impact of the 2010 law. Methods: Data on all
oral antibiotic sales having occurred in the private sector in SSP from
2008 to 2012 were pooled into the 645 municipalities of SSP. Linear
regression was performed to estimate consumption levels that would have
occurred in 2011 and 2012 if no law regulating OTC sales had been issued
in 2010. These values were compared to actual observed levels, estimating
the effect of this law. Linear regression was performed to find
association of antibiotic consumption levels and of a greater effect of
the law with municipality level data on SED obtained from a nationwide
census. Results: Oral antibiotic consumption in SSP rose from 8.44 defined
daily doses per 1,000 inhabitants per day (DID) in 2008 to 9.95 in 2010,
and fell to 8.06 DID in 2012. Determinants of a higher consumption were
higher human development index, percentage of urban population, density of
private health establishments, life expectancy and percentage of females;
lower illiteracy levels and lower percentage of population between 5 and
15 years old. A higher percentage of females was associated with a
stronger effect of the law. Conclusions: SSP had similar antibiotic
consumption levels as the whole country of Brazil, and they were
effectively reduced by the policy.