General decline in the use of antibiotics in Italy during the Covid-19 pandemica viral infection caused by the Sars-CoV-2 coronavirus, therefore not a direct target of this type of drugs like bacterial diseases. The only exception is azithromycin, with a boom in purchases by hospitals that in the north of the country reached + 200% in the first half of 2020, and an increase in private purchases of over a third in the whole of 2020. This is the antibiotic that ended up in the spotlight in the news in January last because it became unobtainable, producing a shortage alarm that forced the Italian Medicines Agency (Aifa) to reiterate that “no antibiotic is approved, much less recommended, for the treatment of Covid-19”.
The trend is highlighted by ‘The use of antibiotics in Italy – National Report 2020’, drawn up by the National Observatory on the use of AIFA medicines, disseminated and presented today in live streaming on the channels of the national regulatory body.
In Italy, the consumption of antibiotics is higher than the European average, both at the local and hospital level, emerges from the report. The consumption of antibiotics in our country was compared with that of other European countries and the United Kingdom using the European Antimicrobial Consumption Surveillance Network (Esac-net), coordinated by the European Center for Disease Prevention and Control, as a source. (Ecdc), which includes both the provision to be paid by the National Health Service and purchases to be paid by the citizen.
In 2020 – reads the report – there is a marked decrease in the territorial consumption of antibiotics in all EU / See countries (European Economic Area), with the exception of Bulgaria, with a -18.1% compared to 2019 to 14.7 daily defined doses per thousand inhabitants per day (Ddd / 1,000 ab day). This trend can be explained by the measures implemented to contain the Covid-19 pandemic and their impact on the circulation of infectious agents. In Italy territorial consumption is higher than the European average, even if in sharp decline compared to the previous year. We are in ninth place, with 16.5 Ddd / 1,000 ab die. Considering the different categories of antibiotics, the Peninsula ranks above the EU / See average for penicillins, macrolides and lincosamides.
At the hospital level, in 2020 compared to 2019 the average EU / See consumption fell by 11.8% to 1.57 Ddd / 1,000 ab die. In this context, Italy records a value just above the European average, albeit slightly higher than in 2019. We are in sixth place with a consumption of 1.91 Ddd / 1,000 ab die. The categories of antibiotics for which the greatest deviations are observed with above-average consumption are sulfonamides and trimethoprim, macrolides and lincosamides and fluoroquinolones.
In 2020, in Italy, about 3 out of 10 citizens received at least one prescription for antibiotics and on average each patient was on treatment for approximately 14 days during the year.
As for the age groups and gender, the prevalence of use increases with advancing age, exceeding 50% in the over 85-year-old population. A greater consumption of antibiotics is confirmed in the extreme groups, in which there is also a more frequent use for men, while the greater prevalence of use in women is found in the intermediate age groups.
In Italy, antibiotics are prescribed inappropriately in a quarter of cases. A risky use, especially in light of the growing emergency linked to resistant ‘superbugs’, and which is growing according to the report.
From the analysis of general medicine data on outpatient prescriptions of antibiotics for specific infectious diseases – it is summarized in the report – it emerged a prevalence of inappropriate use that exceeds 25% for almost all clinical conditions studied (flu, common cold, laryngotracheitis, pharyngitis and tonsillitis, uncomplicated cystitis). In 2020, the observed estimates are all up compared to the previous year, most evidently for uncomplicated cystitis in women, with the exception of upper respiratory tract infections, for which a reduction in the prevalence of inappropriate use is observed.
CHILDREN – In 2020, 26.2% of the Italian population up to 13 years of age received at least one prescription of systemic antibiotics, with an average of 2 packs for each child treated. In 2019 the same statute of limitations was 40.9%, therefore a sharp decrease in a year, the report emerges. A significant reduction is observed in all regions compared to 2019.
“The highest level of exposure is found in the range between 2 and 5 years, in which about one in three children receives at least one prescription for antibiotics. The prescription rate is higher in boys than in girls, especially in the 0-1 year range” , remembers Aifa.
MAGRINI – Aifa’s ‘Use of antibiotics’ report “shows a situation in Italy and in Europe is highly worrying about the use of antibiotics albeit with slight signs of improvement on the use of the same. A patchy situation for resistance persists and Italy is configured as a high-rate country and among the worst in Europe “said Nicola Magrini, director general of the Italian drug agency, in his introduction to the presentation in Rome. of the report.
“There Most antibiotics are used inappropriately in even the mildest patients. We think of bronchitis, sinusitis and ear infections. The most significant word on this day dedicated to the optimal use of antibiotics is thriftiness, necessary to improve their use “underlined Magrini.
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