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

Authors Orlando V, Monetti VM, Moreno Juste A, Russo V, Mucherino S, Trama U, Guida A, Menditto E

Received 12 July 2019

Accepted for publication 31 December 2019

Published 29 January 2020 Volume 2020:13 Pages 63—71

DOI https://doi.org/10.2147/RMHP.S223042

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Kent Rondeau


Valentina Orlando,1 Valeria Marina Monetti,1 Aida Moreno Juste,2,3 Veronica Russo,1 Sara Mucherino,1 Ugo Trama,4 Antonella Guida,5 Enrica Menditto1

1CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy; 2Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC ISCIII, Zaragoza, Spain; 3Aragon Health Service (SALUD), Zaragoza, Spain; 4Regional Pharmaceutical Unit, Campania Region, Naples, Italy; 5Directorate-General for Protection of Health, Campania Region, Naples, Italy

Correspondence: Valentina Orlando
CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Via Domenico Montesano 49, Naples 80131, Italy
Tel +39 081 678657
Fax +39 081 678303
Email valentina.orlando@unina.it

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.

Keywords: antibiotic use, drug utilization, prescription patterns, real-world data


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