Zavaleta Esteban, Ferrara Francesco, Zovi Andrea, Díaz-Madriz José Pablo, Fallas-Mora Abigail, Serrano-Arias Bruno, Valentino Filomena, Arguedas-Chacón Sebastián, Langella Roberto, Trama Ugo, Nava Eduardo
Pharmacy, Hospital Clinica Biblica, San Jose, CRI.
Pharmacy, Asl Napoli 3 Sud, Napoli, ITA.
Cureus. 2023 Jul 5;15(7):e41414. doi: 10.7759/cureus.41414. eCollection 2023 Jul.
The increasing emergence and spread of drug-resistant pathogens resulting from inappropriate antibiotic usage have become more evident in recent years, particularly with the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Since joining the Organization for Economic Cooperation and Development (OECD), Costa Rica can now compare its healthcare system with other countries, and similarities have been noted with Italy regarding health indicators. Both nations have universal healthcare systems, covering their entire populations, and hold similar positions in the Human Development Index (HDI). Consequently, the goal is to compare antibiotic prescribing and consumption patterns to collaboratively develop strategies against bacterial resistance.
In order to compare antibiotic consumption between regions, a standardized contrast was utilized, specifically using the defined daily dose (DDD). An Orthogonal Contrast test was performed to test the means, followed by the application of the Student's t-test on these contrasts. This analysis aimed to assess the potential influence of regions on DDD values. Antibiotic consumption data were collected between January 2021 and December 2022 from the Local Health Authority of Naples 3 South (LHANS) in Italy and IMS Health, Q Quintiles, and VIA by way of (IQVIA) reports in Costa Rica.
LHANS shows a considerable disparity in gross expenditure compared to Italy's overall expenditure, while the private sector of Costa Rica exhibits even lower gross expenditure than Italy. Antibiotic consumption in Italy exceeds that of Costa Rica, with Costa Rica's consumption amounting to 47.70% of Italy's total consumption. Additionally, LHANS exhibited a 22.43% higher gross expenditure compared to the Campania region, emphasizing the variability in antibiotic usage within the same country The results indicated no statistically significant differences in antibiotic consumption between the regions, as none of the null hypotheses were rejected.
The study provides valuable insights into expenditure patterns and antibiotic consumption, highlighting the need for improved prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings emphasize the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.
近年来，因抗生素使用不当导致的耐药病原体不断出现和传播，这一现象愈发明显，尤其是耐甲氧西林金黄色葡萄球菌（MRSA）感染的发病率不断上升。自加入经济合作与发展组织（OECD）以来，哥斯达黎加现在可以将其医疗体系与其他国家进行比较，并且在健康指标方面与意大利存在相似之处。两国都拥有覆盖全体人口的全民医疗体系，并且在人类发展指数（HDI）中处于相似位置。因此，目标是比较抗生素处方和消费模式，以共同制定应对细菌耐药性的策略。
为了比较不同地区的抗生素消费情况，采用了标准化对比，具体使用限定日剂量（DDD）。进行了正交对比检验以检验均值，随后对这些对比应用学生t检验。该分析旨在评估地区对DDD值的潜在影响。抗生素消费数据于2021年1月至2022年12月期间，从意大利那不勒斯3南区地方卫生局（LHANS）以及哥斯达黎加通过艾昆纬（IQVIA）报告中的艾美仕市场研究公司、昆泰公司和威朗公司收集。
与意大利的总支出相比，LHANS的总支出存在显著差异，而哥斯达黎加的私营部门总支出甚至低于意大利。意大利的抗生素消费量超过哥斯达黎加，哥斯达黎加的消费量占意大利总消费量的47.70%。此外，与坎帕尼亚地区相比，LHANS的总支出高出22.43%，这凸显了同一国家内抗生素使用的差异。结果表明，各地区之间的抗生素消费在统计学上没有显著差异，因为所有原假设均未被拒绝。
该研究为支出模式和抗生素消费提供了有价值的见解，强调了改善处方行为和开展宣传活动以解决抗生素耐药性问题的必要性。研究结果强调了实施国际准则以应对抗生素耐药性日益增长的威胁并确保有效管理传染病的重要性。
