Vaccheri Alberto, Bjerrum Lars, Resi Davide, Bergman Ulf, Montanaro Nicola
Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, Via Irnerio 48, I-40126 Bologna, Italy.
J Antimicrob Chemother. 2002 Dec;50(6):989-97. doi: 10.1093/jac/dkf239.
To compare antibiotic prescribing in primary care in two European populations, one in Denmark (Funen), the other in Italy (Ravenna).
Reimbursement data (1999) were retrieved from the Odense Pharmacoepidemiologic Database (Denmark) and the Emilia Romagna Health Authority Database (Italy). The extent of antibiotic use (ATC J01) was analysed as the number of defined daily doses per 1000 inhabitants per day (DDD/1000 inhabitants/day), and as annual prevalence of use. A qualitative analysis was carried out according to the Drug Utilization 90% (DU90%) approach.
Antibiotic consumption was 16.5 DDD/1000 inhabitants/day in Ravenna and 10.4 DDD/1000 inhabitants/day in Funen; the annual prevalence of use was 40 and 30 subjects/100 inhabitants, respectively. Italian children received a greater amount (four-fold in DDDs) of antibiotics than Danish ones, whereas consumption was only slightly higher in Italy than in Denmark in the other age groups. In Italy, injectable antibiotics (third generation cephalosporins or aminoglycosides) accounted for 4% of total DDDs and 11% of exposed subjects. In Funen, use of injectable antibiotics was negligible. The bulk of prescription (90% of total DDDs) was made up of eight (out of 38) different antibiotics in Denmark, mainly narrow-spectrum penicillins and macrolides (1st: phenoxymethylpenicillin), and of 18 (out of 74) antibiotics in Italy, mainly broad-spectrum penicillins, macrolides, fluoroquinolones and cephalosporins.
These data show remarkable differences in antibiotic prescribing between Italy and Denmark, and suggest possible overuse and misuse of antibiotics in Italy.
比较两个欧洲人群(丹麦菲英岛和意大利拉文纳)初级保健中的抗生素处方情况。
从欧登塞药物流行病学数据库(丹麦)和艾米利亚-罗马涅地区卫生当局数据库(意大利)检索1999年的报销数据。抗生素使用程度(解剖学治疗学化学分类系统J01)分析为每1000居民每天的限定日剂量数(DDD/1000居民/天)以及年度使用患病率。根据药物利用90%(DU90%)方法进行定性分析。
拉文纳的抗生素消耗量为16.5 DDD/1000居民/天,菲英岛为10.4 DDD/1000居民/天;年度使用患病率分别为每100居民40例和30例。意大利儿童接受的抗生素量(DDD数为四倍)比丹麦儿童多,而在其他年龄组中,意大利的消耗量仅略高于丹麦。在意大利,注射用抗生素(第三代头孢菌素或氨基糖苷类)占总DDD数的4%,占使用抗生素患者的11%。在菲英岛,注射用抗生素的使用可忽略不计。丹麦处方的大部分(总DDD数的90%)由38种不同抗生素中的8种组成,主要是窄谱青霉素和大环内酯类(第一位:苯氧甲基青霉素),而意大利由74种抗生素中的18种组成,主要是广谱青霉素、大环内酯类、氟喹诺酮类和头孢菌素类。
这些数据显示意大利和丹麦在抗生素处方方面存在显著差异,并表明意大利可能存在抗生素过度使用和滥用的情况。