In 2021 the trend of reducing the use of antibiotics in Italy will continue (-3,3% compared to 2020), although consumption is still higher than that of many European countries.
In the European comparison, a greater use of broad-spectrum antibiotics also emerges in Italy, which have a higher impact on the development of antibiotic resistance. A wide regional variability in consumption is confirmed, with significant margins for improvement of the prescribing appropriateness especially in the Southern Regions.
These are some of the elements that emerge from the Report "The use of antibiotics in Italy - 2021", edited by the National Observatory on the Use of Medicines (OsMed) of AIFA, published on the Agency's portal.
The analysis of antibiotic use in outpatient care also includes a focus on prescribing in the pediatric and elderly populations, fluoroquinolone prescriptions in specific subgroups of the population, and antibiotic use in patients with chronic obstructive pulmonary disease (COPD). ).
The Report also examines the use of antibiotics in hospital settings, the private purchase of class A antibiotics, the consumption of non-systemic antibiotics and the indicators of prescribing appropriateness in the context of general medicine.
The new edition also presents a section on the network of microbiology laboratories and, in accordance with the provisions of the National Antimicrobial Resistance Contrast Plan (PNCAR) 2022-2025, and a section that takes into consideration the use of antibiotics in the field veterinarian.
Finally, as in recent years, the Report provides an assessment of the impact of the COVID-19 pandemic on the consumption of antibiotics in the context of contracted pharmaceutical assistance and purchases by public health facilities, which also includes the first half of the 2022.
The temporal trends in consumption and the important differences in the prescribing patterns between geographical areas that emerge from the data in the Report highlight the importance of continuing to monitor, both at a national and regional or local level, the consumption and quality indicators of antibiotic prescriptions in Italy, as also recommended by the new PNCAR 2022-2025.
HIGHLIGHTS
- The trend of reducing the consumption of antibiotics in Italy continues: -3,3% in 2021 compared to 2020
- In 2021, about 3 out of 10 citizens received at least one prescription for antibiotics, with a prevalence that increases with age, reaching 50% in the over 85s.
- In the pediatric population, the greatest consumption is concentrated in the age group between 2 and 5 years, in which about 4 out of 10 children received at least one prescription of antibiotics during the year.
- 76% of the doses used were provided by the National Health Service (SSN).
- Almost 90% of the antibiotics reimbursed by the NHS are distributed in the area (under an agreed assistance regime).
- More than a quarter of territorial consumption (26,3%) corresponds to private purchases of antibiotics reimbursable by the NHS (class A).
- Penicillins in combination with beta-lactamase inhibitors are confirmed as the class with the highest consumption (36% of total consumption), followed by macrolides and fluoroquinolones.
- There is still a wide regional variability in consumption paid by the NHS, which is greater in the South than in the North and in the Centre. In addition, the largest reductions were recorded in the Northern regions (-6,1%), while in the South they were more contained (-2,2%).
- In the Southern Regions there is a predilection for the use of second choice antibiotics.
- Overall, consumption in Italy remains higher than in many European countries.
- Italy confirms itself as one of the European countries with the greatest use of broad-spectrum molecules, with the greatest impact on antibiotic resistance and therefore considered second-line, with a worsening trend in the last two years.
- Italy is also one of the countries with the lowest share of antibiotics of the "Access" group (47%), considered antibiotics of first choice, which according to the WHO should constitute at least 60% of total consumption.
- In the hospital setting, an increase in the use of antibiotics indicated for the treatment of infections caused by multi-resistant microorganisms is observed in particular.
- Both consumption under the agreed care regime and purchases by public healthcare facilities increased in the first half of 2022 compared to the same period of the previous year.