Orlando Valentina, Monetti Valeria Marina, Moreno Juste Aida, Russo Veronica, Mucherino Sara, Trama Ugo, Guida Antonella, Menditto Enrica
CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC ISCIII, Zaragoza, Spain.
Risk Manag Healthc Policy. 2020 Jan 29;13:63-71. doi: 10.2147/RMHP.S223042. eCollection 2020.
The purpose was to analyze drug prescription and antibiotic use by age and sex in Italy's Campania Region, and to estimate the distribution of prescription rates in children (≤14 years old), adults (between 15 and 65 years old), and older adults (≥65 years old) at a municipality level.
This was a retrospective analysis of pharmacy records in Campania (Southern Italy), in 2016. Difference in antibiotic prescriptions in different age groups was assessed by prevalence rates. Age-adjusted prevalence rates were categorized into quintiles and mapped by the patient's municipality of residence. Relationship between prevalence rates for the different age groups was estimated using the non-parametric Spearman rank correlation test.
There were 2,738,118 were patients with at least one antibiotic prescription. Antibiotics prescription was higher in children aged <5 years and in the older adults aged >70 years. Prevalence rate distribution was different among municipalities in all age groups. A positive correlation between the rank distribution of prevalence rates at municipality level was identified for children and adults (rs=0.56; <0.01), adults and the older adults (rs=0.79; <0.01), and children and the older adults (rs=0.46; <0.01). Among the studied age groups, the most prescribed antibiotic class was penicillin (except the older adults aged ≥85 years) ranging from 45% in children to 27.2% in the older adults. Fluoroquinolones were the least prescribed antibiotic class, ranging from 0.2% in children to 30.2% in the older adults.
A considerably high use of antibiotic drugs has been detected in Campania Region, with values exceeding the regional and national average. Prescriptions at municipal level differ from one age group to another. Antibiotic use is often unjustified, and to decrease the number of prescriptions and improve their appropriateness, several measures at territorial level are recommended.
分析意大利坎帕尼亚地区按年龄和性别划分的药物处方及抗生素使用情况，并估计市镇层面儿童（≤14岁）、成年人（15至65岁）和老年人（≥65岁）的处方率分布。
这是一项对2016年意大利南部坎帕尼亚地区药房记录的回顾性分析。通过患病率评估不同年龄组抗生素处方的差异。年龄调整后的患病率分为五分位数，并按患者居住的市镇绘制地图。使用非参数Spearman等级相关检验估计不同年龄组患病率之间的关系。
有2,738,118名患者至少有一张抗生素处方。5岁以下儿童和70岁以上老年人的抗生素处方率较高。所有年龄组的市镇患病率分布不同。在市镇层面，儿童与成年人（rs = 0.56；<0.01）、成年人与老年人（rs = 0.79；<0.01）以及儿童与老年人（rs = 0.46；<0.01）的患病率等级分布之间存在正相关。在所研究的年龄组中，最常开具的抗生素类别是青霉素（85岁及以上老年人除外），儿童中的比例为45%，老年人中的比例为27.2%。氟喹诺酮类是开具最少的抗生素类别，儿童中的比例为0.2%，老年人中的比例为30.2%。
在坎帕尼亚地区检测到抗生素药物的使用量相当高，数值超过地区和国家平均水平。市镇层面的处方因年龄组而异。抗生素的使用往往不合理，为了减少处方数量并提高其合理性，建议在地区层面采取多项措施。
