caa a22 4500 475818903 CHVBK 20180406123817.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s002280000165 doi (NATIONALLICENCE)springer-10.1007/s002280000165 Pattern of antibiotic use in primary health care in Italy [Elektronische Daten] [A. Vaccheri, C. Castelvetri, E. Esaka, A. Del Favero, N. Montanaro] Objective: The overuse and misuse of antibiotics have been related to the growing emergence of bacterial resistance. The aim of the present study was to assess the pattern of antibiotic use by Italian general practitioners (GPs) in the treatment of the most frequent infectious problems. Methods: The study was performed with 131 GPs recruited on a voluntary basis from among the 181 GPs contacted in two Italian regions, Emilia Romagna and Umbria. GPs were requested to report all the infectious events encountered during six sample weeks on a special form, whether an antibiotic was administered or not. Results: The GPs reported 7095 infectious cases, of which 5036 (77%) were respiratory-tract infections (RTIs) and 749 (11%) were urinary-tract infections (UTIs). Antibiotics were prescribed in 71% of the cases. The proportion of antibiotic-treated cases was highest in UTIs (97%), followed by lower respiratory-tract infections (LRTIs; 93%) and upper respiratory-tract infections (URTIs; 54%). Drugs belonging to 16 Anatomical Therapeutical Chemical groups (fourth level) were used. Wide-spectrum penicillins and macrolides ranked first (23%), followed by penicillins plus β-lactamase inhibitors (15%), cephalosporins (15%) and fluoroquinolones (10%). The most prescribed antibiotics for the major disease groups were wide-spectrum penicillins for URTIs (36%), macrolides and cephalosporins for LRTIs (27% each) and fluoroquinolones for UTIs (46%). Conclusions: The present survey showed a high level of inappropriate use. In fact, a large number of infectious diseases, including infections commonly caused by viral agents, were treated with an anti-bacterial drug. Italian GPs had a tendency to preferentially prescribe wide-spectrum antibiotics and to use, in many cases, antibiotics that are rarely of choice in primary health care, such as cephalosporins and fluoroquinolones. In order to attain a more evidence-based prescription, local guidelines shared by specialists and GPs should be implemented. Springer-Verlag Berlin Heidelberg, 2000 Key words Antibiotics nationallicence Drug utilisation nationallicence Primary health care nationallicence Vaccheri A. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut Castelvetri C. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut Esaka E. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut Del Favero A. Interuniversity Research Centre on Pharmacoepidemiology, Department of Clinical and Experimental Medicine, Section of Internal Medicine and Oncological Sciences, University of Perugia, Perugia, Italy, IT aut Montanaro N. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy e-mail: n.mont@biocfarm.unibo.it Tel.: +39-051-248526; Fax: +39-051-248862, IT aut https://doi.org/10.1007/s002280000165 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280000165 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vaccheri A. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut NATIONALLICENCE 700 1- Castelvetri C. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut NATIONALLICENCE 700 1- Esaka E. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy, IT aut NATIONALLICENCE 700 1- Del Favero A. Interuniversity Research Centre on Pharmacoepidemiology, Department of Clinical and Experimental Medicine, Section of Internal Medicine and Oncological Sciences, University of Perugia, Perugia, Italy, IT aut NATIONALLICENCE 700 1- Montanaro N. Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, via Irnerio 48, I-40126 Bologna, Italy e-mail: n.mont@biocfarm.unibo.it Tel.: +39-051-248526; Fax: +39-051-248862, IT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer