Laboratory for Quality Assessment of Geriatric Therapies and Services, Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20156 Milan, Italy.
Infection. 2011 Aug;39(4):299-308. doi: 10.1007/s15010-011-0129-1. Epub 2011 Jun 25.
We assessed the antibiotic patterns of use and geographical distribution of prevalence and consumption by age in 15 Local Health Units (LHUs) of Italy's Lombardy region.
A retrospective analysis of reimbursement data for the community-dwelling population in 2005 was performed. Prescriptions reimbursed by the National Health System and consumption as defined daily doses (DDD) per 1,000 inhabitants per day (DID) were analyzed. A logistic regression was performed to evaluate the association between antibiotic drug prescription and age, gender, and LHU of residence of the population.
During 2005, a total of 3,120,851 people (34% of the population) received at least one antibiotic drug prescription. The highest prescription prevalence was observed in the 0-17 and 80 or more years age ranges (41.6 and 41.9%, respectively). Large differences were found in the prevalence rates between different LHUs (ranging from 28.7% in Milan to 39.4% in Brescia) and in DID (ranging from 12.6 DID in Sondrio to 18.9 DID in Brescia). The age and residence of the population were the main determinants of drug exposure. In particular, patients aged <18 years (odds ratio [OR] = 1.73; 95% confidence interval [CI] 1.73, 1.74), aged 65 years or older (OR = 1.64; 95% CI 1.63, 1.65), and those that live in Brescia (OR = 1.66; 95% CI 1.65, 1.66) had a statistically significant higher risk of antibiotic drug exposure.
The observed intra-regional differences underline the need for a careful monitoring with the aim to reduce antibiotic resistance and improve the rational use of drugs.
我们评估了意大利伦巴第地区 15 个地方卫生单位（LHUs）的抗生素使用模式、按年龄分布的流行率和消费情况。
对 2005 年社区居住人群的报销数据进行了回顾性分析。分析了国家卫生系统报销的处方和按每 1000 居民每日定义剂量（DDD）计算的消费（DID）。进行了逻辑回归，以评估抗生素药物处方与年龄、性别和居民居住的 LHU 之间的关联。
2005 年，共有 3120851 人（占人口的 34%）接受了至少一次抗生素药物处方。0-17 岁和 80 岁及以上年龄组的处方患病率最高（分别为 41.6%和 41.9%）。不同 LHUs 之间的患病率差异很大（从米兰的 28.7%到布雷西亚的 39.4%），DDD 也存在差异（从松德里奥的 12.6 DID 到布雷西亚的 18.9 DID）。人口的年龄和居住地是药物暴露的主要决定因素。特别是，<18 岁的患者（比值比[OR] = 1.73；95%置信区间[CI] 1.73，1.74）、65 岁及以上的患者（OR = 1.64；95% CI 1.63，1.65）和居住在布雷西亚的患者（OR = 1.66；95% CI 1.65，1.66）抗生素药物暴露的风险显著增加。
观察到的区域内差异表明需要进行仔细监测，以减少抗生素耐药性并改善药物的合理使用。
