This paper studies the spread of antibiotic resistance and its determinants, relying on unique data at state, year, bacteria, and drug level, covering all US states. I relate antibiotic resistance to the use of antibiotics in human prescription and animal production in a triple difference-indifference design to control for confounders. Despite that animal production absorbs most of the antibiotic production, the results show that the main determinant of resistance is in fact human prescriptions, emphasizing the role of policies targeting hospitals and ambulatory care. Resistance is particularly sensitive to antibiotic use for newer drugs.
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Jérôme Adda (2020) studied this question.
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