The Role of Structural Factors in Antibiotic Use Among European Union Citizens: A Multilevel Analysis

Using the 2016 European Commission's Eurobarometer survey, this study analyzed how a multitude of factors are associated with identification and intention of following proper antibiotic treatment. Multilevel analyses showed that knowledge and information from medical professionals and mass media (individual-level predictors), and advanced access to education (a structural-level factor) are associated with identification. For intention, structural factors (Access to Information & Communications, Health & Wellness, Nutrition & Basic Medical Care) contributed significant variances to the model, in addition to the individual-level effects (sources and trust in medical professionals and mass media). Results demonstrate a need to consider these structural-level influences to shed light on the process though which antibiotic resistance preventions and interventions might impact individuals' health literacy and behavioral outcomes