Napolitano Francesco, Pelullo Concetta Paola, Lamberti Monica, Donnarumma Giovanna, Di Giuseppe Gabriella
Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni 5, 80138 Naples, Italy.
Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina 40, 80133 Naples, Italy.
Antibiotics (Basel). 2023 Jan 20;12(2):218. doi: 10.3390/antibiotics12020218.
This study aims to evaluate the antimicrobial prescribing practices in hospital settings in Italy, focusing on the appropriateness of antibiotic use.
This study was carried out through a retrospective review of medical records of patients admitted in three public hospitals located in Campania Region (Italy) between 1 January and 31 December 2018.
More than one third (34.2%) of patients received at least one inappropriate antibiotic prescription (antibiotic administered and not indicated). Being female, having a >1 Charlson comorbidity index score, and having a longer hospital stay were significant determinants of an inappropriate antibiotic prescription. Instead, patients who had had a non-urgent hospital admission, an infection on hospital admission, and a microbiological culture test during hospital stay were significantly less likely to have an inappropriate prescription. When the antibiotic prescriptions were analyzed, in 26.6% of cases they were not indicated, while among the 687 antibiotic prescriptions with indication, incorrect choice of antibiotics (36.8%) was the most common reason of the inappropriateness.
The findings of the study indicate that the inappropriate use of antibiotics continues to be a relevant issue in the hospital setting and specific interventions are needed to encourage a wider utilization of diagnostic tools to practice targeted therapies and to counter the antimicrobial resistance.
本研究旨在评估意大利医院环境中的抗菌药物处方实践，重点关注抗生素使用的合理性。
本研究通过回顾性分析2018年1月1日至12月31日期间在意大利坎帕尼亚地区三家公立医院住院患者的病历进行。
超过三分之一（34.2%）的患者接受了至少一张不适当的抗生素处方（使用了未指明的抗生素）。女性、Charlson合并症指数评分>1以及住院时间较长是不适当抗生素处方的重要决定因素。相反，非紧急入院、入院时感染以及住院期间进行微生物培养检测的患者开具不适当处方的可能性显著降低。在分析抗生素处方时，26.6%的病例未指明使用抗生素，而在687张有指征的抗生素处方中，抗生素选择不当（36.8%）是最常见的不适当原因。
研究结果表明，抗生素的不当使用在医院环境中仍然是一个相关问题，需要采取具体干预措施，以鼓励更广泛地使用诊断工具来实施靶向治疗，并应对抗菌药物耐药性。
