The project dataset has been modified from a real study investigating risk factors associated with antimicrobial drug consumption. For the purpose of maintaining confidential data, the locations have
been made anonymous and only per capita values for drug consumption are available for your use.
For the purpose of this study, assume that a cross-sectional community level study was conducted in
2009 to investigate the impact of socio-economic and demographic factors, H1N1 influenza rates, and
vaccination-levels on the consumption of antimicrobial drugs.
**Background and questions:**
Antimicrobial drugs are used to treat a variety of bacterial infections. Although these drugs are
ineffective against viral infections, they are sometimes prescribed due to both real and perceived
pressures on physicians to provide a treatment. A lack of understanding concerning the difference
between viral and bacterial infections is often cited as an important factor in a patient’s understanding
of whether an antimicrobial should be prescribed. Similarly, the number of health workers in a
community may influence whether a physician has adequate time to deal with these issues. In addition,
demographic and socio-economic factors also influence the amount and types of antimicrobials that
may be prescribed in a community. The development of antimicrobial resistance through the
inappropriate prescribing of these drugs is a concern in the medical community. Antimicrobial
consumption in a community can be measured in the number of prescriptions, dollars spent, and
defined daily doses (DDDs). A DDD is defined by the World Health Organization as “the assumed
average maintenance dose per day for a drug used for its main indication in adults”, and is used to
standardize the use of various drugs for comparative purposes.
For the dataset, assume you have a measure of azithromycin (an antimicrobial drug)
consumption in defined daily doses per 10,000 population in 2009 from 400 Canadian communities
and you are being asked to determine if there is any association with the socio-economic, demographic
and influenza H1N1 related factors that were measured at the community-level (i.e., an ecological
study).
