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Hospital Antibiotic Use during COVID-19 Pandemic in Italy

Antimicrobial resistance (AMR) represents a major issue in healthcare being correlated to global inappropriate use of antibiotics. The aim of this study was to compare the data on hospital antibiotic consumption in 2020–2021 with those related to 2019 in order to evaluate the impact of the COVID-19...

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Autores principales: Perrella, Alessandro, Fortinguerra, Filomena, Pierantozzi, Andrea, Capoluongo, Nicolina, Carannante, Novella, Lo Vecchio, Andrea, Bernardi, Francesca Futura, Trotta, Francesco, Cangini, Agnese
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854455/
https://www.ncbi.nlm.nih.gov/pubmed/36671369
http://dx.doi.org/10.3390/antibiotics12010168
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author Perrella, Alessandro
Fortinguerra, Filomena
Pierantozzi, Andrea
Capoluongo, Nicolina
Carannante, Novella
Lo Vecchio, Andrea
Bernardi, Francesca Futura
Trotta, Francesco
Cangini, Agnese
author_facet Perrella, Alessandro
Fortinguerra, Filomena
Pierantozzi, Andrea
Capoluongo, Nicolina
Carannante, Novella
Lo Vecchio, Andrea
Bernardi, Francesca Futura
Trotta, Francesco
Cangini, Agnese
author_sort Perrella, Alessandro
collection PubMed
description Antimicrobial resistance (AMR) represents a major issue in healthcare being correlated to global inappropriate use of antibiotics. The aim of this study was to compare the data on hospital antibiotic consumption in 2020–2021 with those related to 2019 in order to evaluate the impact of the COVID-19 pandemic on antibiotic prescriptions and appropriate use at national level and in the different geographical areas. To estimate the consumption of antibiotics, two indicators were calculated: “number of DDD per 1000 inhabitants per day” and “number of DDD per 100 hospitalisation days”. Consumption data on antibiotics dispensed in public health facilities were based on the Italian “traceability of medicines” information flow. Data on hospitalisation days were extracted from the Italian “hospital discharge form” flow. Pearson correlation analysis was performed between the number of patients hospitalised for COVID-19 and the consumption of antibiotics in public healthcare facilities. During 2020, about 1.7 DDD/1000 inhabitants per day (12.3% of the overall consumption of reimbursed antibiotics) were dispensed exclusively in Italian hospitals (+0.8% compared to 2019). Considering the number of DDD per 100 hospitalisation days, consumption increased by 19.3% in 2020 compared to 2019. Comparing the first semester of 2020 and 2019, a decrease of DDD/1000 inhabitants per day was observed (−1.6%) at national level, with opposite trends in the different geographical areas; an increase in the use of azithromycin and carbapenems was also observed, with a stable consumption of third-generation cephalosporins. The use of antibiotics in the second semester of 2020 compared to the same period of 2019 showed a clear reduction at national level (−8.5%), appreciable to a similar extent in all geographic areas. In the first semester of 2021 compared to the same period of 2020, there was a huge reduction (−31.4%) in consumption at national level. However, the variations were heterogeneous between different geographical areas. To our knowledge, this study represents the most comprehensive analysis performed on antibiotic consumption data in hospital settings in Italy during the COVID-19 pandemic to date. Despite international and national guideline recommendations, a substantial overall increase in antibiotic prescriptions was observed during the COVID-19 pandemic, with variability in terms of geographical distribution and prescription strategies. These findings may be related to the dichotomy between perceived and real significance of guidelines, expert panels, or consensus. Therefore, new approaches or strategies to antimicrobial stewardship should be proposed.
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spelling pubmed-98544552023-01-21 Hospital Antibiotic Use during COVID-19 Pandemic in Italy Perrella, Alessandro Fortinguerra, Filomena Pierantozzi, Andrea Capoluongo, Nicolina Carannante, Novella Lo Vecchio, Andrea Bernardi, Francesca Futura Trotta, Francesco Cangini, Agnese Antibiotics (Basel) Article Antimicrobial resistance (AMR) represents a major issue in healthcare being correlated to global inappropriate use of antibiotics. The aim of this study was to compare the data on hospital antibiotic consumption in 2020–2021 with those related to 2019 in order to evaluate the impact of the COVID-19 pandemic on antibiotic prescriptions and appropriate use at national level and in the different geographical areas. To estimate the consumption of antibiotics, two indicators were calculated: “number of DDD per 1000 inhabitants per day” and “number of DDD per 100 hospitalisation days”. Consumption data on antibiotics dispensed in public health facilities were based on the Italian “traceability of medicines” information flow. Data on hospitalisation days were extracted from the Italian “hospital discharge form” flow. Pearson correlation analysis was performed between the number of patients hospitalised for COVID-19 and the consumption of antibiotics in public healthcare facilities. During 2020, about 1.7 DDD/1000 inhabitants per day (12.3% of the overall consumption of reimbursed antibiotics) were dispensed exclusively in Italian hospitals (+0.8% compared to 2019). Considering the number of DDD per 100 hospitalisation days, consumption increased by 19.3% in 2020 compared to 2019. Comparing the first semester of 2020 and 2019, a decrease of DDD/1000 inhabitants per day was observed (−1.6%) at national level, with opposite trends in the different geographical areas; an increase in the use of azithromycin and carbapenems was also observed, with a stable consumption of third-generation cephalosporins. The use of antibiotics in the second semester of 2020 compared to the same period of 2019 showed a clear reduction at national level (−8.5%), appreciable to a similar extent in all geographic areas. In the first semester of 2021 compared to the same period of 2020, there was a huge reduction (−31.4%) in consumption at national level. However, the variations were heterogeneous between different geographical areas. To our knowledge, this study represents the most comprehensive analysis performed on antibiotic consumption data in hospital settings in Italy during the COVID-19 pandemic to date. Despite international and national guideline recommendations, a substantial overall increase in antibiotic prescriptions was observed during the COVID-19 pandemic, with variability in terms of geographical distribution and prescription strategies. These findings may be related to the dichotomy between perceived and real significance of guidelines, expert panels, or consensus. Therefore, new approaches or strategies to antimicrobial stewardship should be proposed. MDPI 2023-01-13 /pmc/articles/PMC9854455/ /pubmed/36671369 http://dx.doi.org/10.3390/antibiotics12010168 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Perrella, Alessandro
Fortinguerra, Filomena
Pierantozzi, Andrea
Capoluongo, Nicolina
Carannante, Novella
Lo Vecchio, Andrea
Bernardi, Francesca Futura
Trotta, Francesco
Cangini, Agnese
Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title_full Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title_fullStr Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title_full_unstemmed Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title_short Hospital Antibiotic Use during COVID-19 Pandemic in Italy
title_sort hospital antibiotic use during covid-19 pandemic in italy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854455/
https://www.ncbi.nlm.nih.gov/pubmed/36671369
http://dx.doi.org/10.3390/antibiotics12010168
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