# Determinants of private-sector antibiotic consumption in India: findings from a quasi-experimental fixed-effects regression analysis using cross-sectional time-series data, 2011–2019

## TL;DR

This study identifies factors that reduce private-sector antibiotic use in India, showing that economic and social progress, along with public health spending, can significantly lower consumption.

## Contribution

The study uses a quasi-experimental fixed-effects regression to identify key determinants of private-sector antibiotic consumption in India.

## Key findings

- Antibiotic consumption decreased with higher per-capita GDP.
- Increased girls' tertiary education enrollment reduced antibiotic use.
- Higher government health spending led to the largest reduction in antibiotic consumption.

## Abstract

The consumption of antibiotics varies between and within countries. However, our understanding of the key drivers of antibiotic consumption is largely limited to observational studies. Using Indian data that showed substantial differences between states and changes over years, we conducted a quasi-experimental fixed-effects regression study to examine the determinants of private-sector antibiotic consumption. Antibiotic consumption decreased by 10.2 antibiotic doses per 1000 persons per year for every ₹1000 (US$12.9) increase in per-capita gross domestic product. Antibiotic consumption decreased by 46.4 doses per 1000 population per year for every 1% increase in girls’ enrollment rate in tertiary education. The biggest determinant of private sector antibiotic use was government spending on health—antibiotic use decreased by 461.4 doses per 1000 population per year for every US$12.9 increase in per-capita government health spending. Economic progress, social progress, and increased public investment in health can reduce private-sector antibiotic use.