<p>Drug Utilization Pattern of Antibiotics: The Role of Age, Sex and Municipalities in Determining Variation</p>

Abstract

Purpose: 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. Methods: 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. Results: 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; P<0.01), adults and the older adults (rs=0.79; P<0.01), and children and the older adults (rs=0.46; P<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. Conclusion: 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.

A Study of Drug Utilization and Potential Drug-Drug Interactions in Outpatient Pharmacy of a Tertiary Care Teaching Hospital: A Cross-Sectional Observational Study.

“…Beta [13] lactam was the most common class of antibiotic prescribed in this study, which is in accordance with the study conducted by Orlando V et al . [14] 145 out of 400 prescriptions (36.25%) were found to be containing Fixed Dose Combination (FDC) in present study, the nding which coincides with the results reported by Belhekar MN et al Since FDCs reduce the actual quantity of dosage forms to be taken by the patient, it helps to improve the adherence to treatment by increasing compliance of the patients . 78.46 % drugs were found to be prescribed from the [15] National List of Essential Medicines (NLEM) 2015 and 67.22 % drugs were from WHO List of essential medicine 2019 in this study.…”

Development and validation of a clinical risk score to predict the risk of SARS-CoV-2 infection from administrative data: a population-based cohort study from Italy

“…The Campania Region Database (CaReDB) includes information on patient demographics, the electronic records of outpatient pharmacy dispensing and hospital discharges for ~6 million residents of a well-defined population in Italy (~10% of the population of Italy). CaReDB is complete and includes validated data in previous drug utilization studies [9][10][11][12][13][14][15][16][17]. The characteristics of CaReDB are described in S1 Table. From the beginning of the Covid-19 epidemic, a surveillance system was implemented to collect all cases identified by reverse transcription-polymerase chain reaction (RT-PCR) testing for SARS-CoV-2.…”

Geographical Variation in Medication Prescriptions: A Multiregional Drug-Utilization Study

“…In Italy, many health policies are designed and implemented at Regional level. Among these, there may be indications orienting the prescribing practice, essentially with the aim of cost containment (for example, towards the choice of drugs with comparable efficacy but lower costs) or of risk minimization (for example, towards the choice of drugs associated with a better tolerability profile of with less reporting of medication errors or adverse events) (Russo et al, 2018;Orlando et al, 2020).…”

“…Such variations may be dependent upon differences in the prescribing habits of general practitioners (GPs) and socioeconomic status of patients (Odubanjo et al, 2004). Furthermore, variations in prescription patterns among different regions and between areas within the same region in Italy have been documented (Russo et al, 2018;Orlando et al, 2020). For instance, the Italian National Observatory on Drug Prescription (OsMed) revealed that, in 2016, the overall prescription for all reimbursed drugs, expressed in defined daily doses (DDDs) per 1,000 inhabitants per day, was 900.7 in northern Italy and 1,048.8 in southern Italy (Rapporto OsMed, 2018).…”