Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regionale dell'Emilia-Romagna, Bologna, Italy.
Clin Microbiol Infect. 2011 Nov;17(11):1698-703. doi: 10.1111/j.1469-0691.2011.03500.x. Epub 2011 May 20.
Antibiotic resistance is closely related to antibiotic use and Italy is a country with high levels of both antibiotic use and antimicrobial resistance. We analysed the trend in antibiotic use in the community among adults (≥15 years) and elderly, in the period 2003-2009, in Emilia-Romagna, Italy, a region with over 4 000 000 inhabitants. Data regarding antibiotic use were obtained from the regional public health system databases. Between 2003 and 2009 the antibiotic consumption increased from 15.4 to 18.7 defined daily doses/1000 inhabitants per day (DID) (+21.4%, p <0.0001). The prescription rate in 2009 was 2.19 prescriptions/1000 inhabitants per day, an increase of 13.8% compared with 2003. The highest increase in antibiotic use was observed among persons aged 20-59 years (+24.7%). The proportion of inhabitants receiving at least one antibiotic treatment was 36.4% in 2003 and 39.7% in 2009, and the proportions receiving at least three antibiotic treatments were 3.5% and 4.2%, respectively. The H1N1 pandemic was associated, in October and November 2009, with a 37-90% increase in antibiotic use among the 15-19-year and 20-59-year age groups compared with 2007 and 2008. No other difference was observed in any other age group. The analysis per antibiotic class showed increases for penicillin + beta-lactamase inhibitor (from 3.6 to 6.3 DID), quinolones (from 2.6 to 3.0 DID) and macrolides (from 3.1 to 3.7 DID), whereas cephalosporin use was stable (1.4 DID). A steady increase in antibiotic use in the adult population has been observed in the Emilia-Romagna: public health interventions are mandatory to counteract this trend.
抗生素耐药性与抗生素的使用密切相关，意大利是一个抗生素使用量和抗菌药物耐药率都很高的国家。我们分析了 2003-2009 年期间意大利艾米利亚-罗马涅地区（拥有超过 400 万居民）成年人（≥15 岁）和老年人的社区抗生素使用趋势。抗生素使用数据来自于地区公共卫生系统数据库。2003 年至 2009 年间，抗生素的消耗量从 15.4 增至 18.7 日剂量/1000 居民（DDD）（增加 21.4%，p＜0.0001）。2009 年的处方率为 2.19 张/1000 居民/天，与 2003 年相比增加了 13.8%。抗生素使用的增长幅度最大的是 20-59 岁的人群（增加了 24.7%）。2003 年有 36.4%的居民接受了至少一次抗生素治疗，2009 年这一比例增至 39.7%，接受至少三次抗生素治疗的比例分别为 3.5%和 4.2%。2009 年 10 月和 11 月 H1N1 大流行期间，与 2007 年和 2008 年相比，15-19 岁和 20-59 岁年龄组的抗生素使用量分别增加了 37%-90%。在其他任何年龄组都没有观察到其他差异。按抗生素类别分析显示，青霉素+β-内酰胺酶抑制剂（从 3.6 增至 6.3 DDD）、喹诺酮类（从 2.6 增至 3.0 DDD）和大环内酯类（从 3.1 增至 3.7 DDD）的使用有所增加，而头孢菌素的使用保持稳定（1.4 DDD）。艾米利亚-罗马涅地区的成年人的抗生素使用量一直在稳步增加：必须采取公共卫生干预措施来遏制这一趋势。
