scholarly journals Evaluation of antimicrobial consumption in Campania Region, Italy

2008 ◽  
Vol 9 (1) ◽  
pp. 57-62
Author(s):  
Simona Cammarota ◽  
Anna Citarella ◽  
Enrica Menditto ◽  
Simona De Portu
Keyword(s):  
Prescription Drugs ◽  
Age Groups ◽  
Antibiotic Use ◽  
Drug Expenditure ◽  
Elderly Subjects ◽  
Resistant Bacteria ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
Campania Region ◽  
Anatomic Therapeutic Chemical

Introduction: the antibiotic usage in Italy is above the European average. From several years the Campania was the first Italian region in terms of antimicrobial consumption. Aim: to evaluate antibiotic utilisation in primary health care in Campania, a region of approximately 5.7 million inhabitants in the south of Italy. Method: we collected, from an electronic database, all prescription drugs reimbursed in 2005. The cohort was defined as the population of subjects receiving at least one prescription of any antimicrobial agent for systemic use, classified according to their therapeutic role using Anatomic Therapeutic Chemical (ATC) classification. Drugs cost and consumption were quantified using National Health Service (NHS) prospective and Defined Daily Dose system (DDD) respectively. All costs were expressed in Euro 2005. Results: antiinfectives agents (ATC J) was the second class of drugs in terms of cost, representing 16.1% of the regional drug expenditure. Their consumption were 33 DDD/1000 inhabitants/day. Stratifying by age antibiotic use was highest in children and elderly subjects. Penicillins, macrolides and cephalosporins were the most prescribed antibiotic classes in all age groups. Discussion: despite guidelines introduced to limit the prescription of parenteral antibiotics to the patients who are most likely to benefit from it, they were mostly prescribed. This represented a serious problem for the development of drug-resistant bacteria.

scholarly journals Epidemiological and economic aspects of diabetes in the Campania Region, Italy

2008 ◽  
Vol 9 (2) ◽  
pp. 89-94
Author(s):  
Simona Cammarota ◽  
Andrea Morsanutto ◽  
Enrica Menditto ◽  
Anna Citarella ◽  
Simona De Portu
Keyword(s):  
Drug Expenditure ◽  
Antidiabetic Drugs ◽  
Control Group ◽  
Diabetic Patients ◽  
Local Health ◽  
Defined Daily Dose ◽  
Concomitant Treatment ◽  
Healthcare Budget ◽  
Campania Region ◽  
Anatomic Therapeutic Chemical

Aim: to assess the economic and epidemiologic impact of diabetes in Campania, a region of approximately 5.7 million inhabitants in the south of Italy. Method: we collected, from an electronic database, all prescriptions for antidiabetic drugs reimbursed in the first half year of 2005 in 8 local health authorities (60% of the overall population) of Campania. The diabetic cohort was defined as the population of subjects receiving at least 2 prescriptions of an antidiabetic agent in 6-month, classified according to their therapeutic role using Anatomic Therapeutic Chemical (ATC) classification. Characterization is given of the patients and their antidiabetic medication. Subsequently, the prescription of concomitant treatment, in comparison with a control group, is presented. Drugs cost and drugs consumption were quantified using NHS prospective (expressed in Euro 2005) and Defined Daily Dose system (DDD) respectively. Results: the diabetic cohort included 183,614 subjects (5.3% of the observed population), mean age was 65.0 years and female represented 54.8% of the sample. Total cost for diabetic patients represents 16.8% of the total drug expenditure. The average drug/cost/patient was € 355.7; only 19.0% was spent for antidiabetic drugs. The reported use of medication was higher for subjects with diabetes compared with the control population regarding overall use (2,363.5 versus 1259.8 DDD/1,000 inhabitants/die), the use of cardiovascular drugs (1,499.3 versus 663.5 DDD/1,000 inhabitants/day), use of haematologic drugs (277.1 versus 120.3 DDD/1,000 inhabitants/day), and use of ophthalmological drugs (48.3 versus 21.0 DDD/1,000 inhabitants/day). Discussion: chronic-degenerative pathologies, such as diabetes, implies a relevant social and economic impact. Expenses that are associated to the treatment and the prevention of complications, in particular cardiovascular problems, are registered among the main items listed in the healthcare budget.

scholarly journals Risk Factors for Development of Multiple-Class Resistance to Streptococcus pneumoniae Strains in Belgium over a 10-Year Period: Antimicrobial Consumption, Population Density, and Geographic Location

2007 ◽  
Vol 51 (10) ◽  
pp. 3491-3497 ◽  
Author(s):  
Johan Van Eldere ◽  
Robertino M. Mera ◽  
Linda A. Miller ◽  
James A. Poupard ◽  
Heather Amrine-Madsen
Keyword(s):  
Risk Factors ◽  
Streptococcus Pneumoniae ◽  
Population Density ◽  
High Resistance ◽  
Antibiotic Use ◽  
Multiple Resistance ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
Time Space ◽  
The Impact

ABSTRACT We investigated the impact of the usage of antibiotics in ambulatory patients in Belgium in 147 defined geographical circumscriptions and at the individual isolate level. The study included 14,448 Streptococcus pneumoniae strains collected by the Belgium national reference lab from 1994 to 2004. Additional risk factors for resistance, such as population density/structure and day care attendance, were investigated for the same time-space window. A statistical model that included resistance to two or more antimicrobial classes offered the best fit for measuring the changes in nonsusceptibility to penicillin, macrolides, and tetracycline over time and place in Belgium. Analysis at the geographic level identified antimicrobial consumption with a 1-year lag (0.5% increase per additional defined daily dose) and population density as independent predictors of multiple resistance. Independent risk factors at the isolate level were age (odds ratio [OR], 1.55 for children aged <5 years), population density (7% increase in multiple resistance per 100 inhabitants/km2), conjugate 7-valent vaccine serotype (OR, 14.3), location (OR, 1.55 for regions bordering high-resistance France), and isolate source (OR, 1.54 for ear isolates). The expansion of multiple-resistant strains explains most of the overall twofold increase and subsequent decrease in single antimicrobial resistance between 1994 and 2004. We conclude that factors in addition to antibiotic use, such as high population density and proximity to high-resistance regions, favor multiple resistance. Regional resistance rates are not linearly related to actual antibiotic use but are linked to past antibiotic use plus a combination of demographic and geographic factors.

scholarly journals Antibiotic use in Albania between 2011 and 2012

2015 ◽  
Vol 9 (01) ◽  
pp. 094-098 ◽  
Author(s):  
Iris Hoxha ◽  
Admir Malaj ◽  
Ledjan Malaj
Keyword(s):  
Antibiotic Use ◽  
World Health ◽  
Measurement Unit ◽  
Defined Daily Dose ◽  
Anatomic Therapeutic Chemical ◽  
Daily Dose ◽  
Health Institutions ◽  
Health Organization ◽  
Official Data

Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.

scholarly journals Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

2017 ◽  
Vol 74 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Majda Sahman-Zaimovic ◽  
Sasa Vukmirovic ◽  
Natasa Tomic ◽  
Nebojsa Stilinovic ◽  
Olga Horvat ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Good Practice ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
National Guidelines ◽  
Duration Of Treatment ◽  
Anatomic Therapeutic Chemical ◽  
The Republic ◽  
Tract Infections

Background/Aim. The overuse of antibiotics unnecessarily exposes patients to risk of side effects, encourages reconsultation for similar problems and enhances antimicrobial resistance. The use of antibiotics in the year 2011 in Montenegro was high (39.05 Defined Daily Dose ? DDD/1,000 inhabitants/day), but it was not considered in relation to the frequency of bacterial diseases. The aim of our study was to determine the degree of conformance between the amount of outpatient antibiotic consumption and the reported prevalence of outpatient bacterial infections in the Republic of Montenegro. Methods. Data on the use of antibacterial drugs was obtained from the Agency for Medicines and Medical Devices of Montenegro for the year 2012. The amount of antibiotics was calculated using the Anatomic Therapeutic Chemical (ATC) DDD methodology. Data on the prevalence of outpatient infective disease was obtained from the Health Statistical Yearbook 2012 of Montenegro and it was expressed per 1,000 inhabitants. Results. A total of 30.34 DDD/1,000 inhabitants/day of antibiotics in outpatients were prescribed in Montenegro in 2012, with penicillins being most frequently prescribed. Amoxicillin and amoxicillin with clavulanic acid were the most frequently used antibiotics. The prevalence of outpatient bacterial infections was 6,745 cases or 10.87/1,000. The most frequent infections were respiratory tract infections. Less than 50% of the prescribed amount of antibiotics were prescribed in accordance with national guidelines on treatment of bacterial infections. Conclusion. Use of antibiotics in Montenegro in 2012 was more than double than necessary according to prevalence of bacterial infections and average duration of treatment. The structure of antibiotics was not in full compliance with the national good practice guidelines, but it was in accordance with data on bacterial antibiotic resistance in outpatient practice. It is necessary to initiate measures to rationalize the use of antibiotics both in terms of quantity and in terms of the structure of the most used antibiotics.

scholarly journals Alpha Spectrometry of Radon Short-Lived Progeny in Drinking Water and Assessment of the Public Effective Dose: Results from the Cilento Area, Province of Salerno, Southern Italy

Materials ◽  
2020 ◽  
Vol 13 (24) ◽  
pp. 5840
Author(s):  
Enver Faella ◽  
Simona Mancini ◽  
Michele Guida ◽  
Albina Cuomo ◽  
Domenico Guida
Keyword(s):  
Drinking Water ◽  
Effective Dose ◽  
Health Hazard ◽  
Age Groups ◽  
Internal Exposure ◽  
Threshold Values ◽  
Campania Region ◽  
Radon Activity ◽  
National Regulation ◽  
South Italy

Radon is a naturally occurring radioactive gas present in the hydrosphere, lithosphere and atmosphere abundantly. Its ionizing radiation provides the largest human internal exposure by inhalation and ingestion to natural sources, constituting a serious health hazard. The contribution to total exposure is mainly due to inhalation, as ingestion by food or drinking water is typically very small. However, because of public health concerns, the contributions from all these sources are limited by regulations and remedial action should be taken in the event that the defined threshold values are overcome. In this paper, the first campaign of measurements to control the radon activity concentration in drinking water from public water supplies in the province of Salerno, south Italy, is described. The results represent a main reference for the area, as it was never investigated before. The purpose of this survey was to contribute to data compilation concerning the presence of radon-222 in groundwater in the Campania region and to determine the associated risk for different age groups. The maximum radon activity concentrations and the related total annual public effective dose turned out to be lower than the threshold values (100 Bq/l and 0.1 mSv/y, respectively) indicated by international guidelines and the national regulation, showing that the health risks for public consumption can be considered negligible.

scholarly journals The Pelvic Incidence Stratified Sagittal Spinopelvic Alignment in Asymptomatic Chinese Population With Different Age Groups

2021 ◽  
pp. 219256822198964
Author(s):  
Siyu Zhou ◽  
Zhuoran Sun ◽  
Wei Li ◽  
Da Zou ◽  
Weishi Li
Keyword(s):  
Chinese Population ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Age Groups ◽  
Vertical Axis ◽  
Elderly Subjects ◽  
Sagittal Vertical Axis ◽  
Cross Sectional ◽  
Sagittal Parameters ◽  
Very High

Study Design: Cross-sectional study. Objective: To provide the age- and pelvic incidence-related variations of sagittal alignment in asymptomatic Chinese population. Methods: This study recruited asymptomatic adult subjects. All subjects undertook the standing whole spinal radiograph and the sagittal parameters were measured: sagittal vertical axis (SVA), T1 pelvic angle (TPA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI) and pelvic tilt (PT). All subjects were divided into young, middle aged and elderly groups, then each age group was further divided into 5 subgroups (very low, low, average, high and very high) based on PI values. The relations between PI, age and other parameters were evaluated. The differences in sagittal parameters of each PI subgroup were compared. Results: 546 subjects were included with an average age of 38.6 years (18 to 81). The number of subjects over 70 years and with very low PI was relatively small. The average of PI, TPA, PT and LL were 45.9° ± 8.4°, 6.4° ± 6.2°, 11.9° ± 6.6° and 49.2° ± 10.1°, respectively. SVA, TPA, TK and PT increased with age ( P < 0.05), while SVA, TPA, PT, PI-LL also increased with PI ( P < 0.05). LL, PT, TPA, PI-LL and LL-TK were different among the 5 PI subgroups ( P < 0.05). However, the values of LL in elderly subjects with high and very high PI were similar. Conclusion: The age- and PI-related variations in sagittal alignment of Chinese population were provided. The sagittal parameters were significantly influenced by age and PI. The individual pelvic morphology should be carefully considered during the assessment and restoration of sagittal balance.

scholarly journals Tetracycline-Resistant Bacteria Selected from Water and Zebrafish after Antibiotic Exposure

2021 ◽  
Vol 18 (6) ◽  
pp. 3218
Author(s):  
Ana Rita Almeida ◽  
Marta Tacão ◽  
Joana Soares ◽  
Inês Domingues ◽  
Isabel Henriques
Keyword(s):  
Statistical Significance ◽  
Recovery Period ◽  
Antibiotic Resistance Genes ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Potential Impact ◽  
Susceptibility Profiles ◽  
Selection Of ◽  
Significant Mortality

The emergence of antibiotic-resistant pathogens due to worldwide antibiotic use is raising concern in several settings, including aquaculture. In this work, the selection of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) was evaluated after exposure of zebrafish to oxytetracycline (OTC) for two months, followed by a recovery period. The selection of ARB in water and fish was determined using selective media. The abundance of tetA genes was estimated through qPCR. Higher prevalence of ARB was measured in all samples exposed to the antibiotic when compared to control samples, although statistical significance was only achieved five days after exposure. Isolates recovered from samples exposed to the antibiotic were affiliated with Pseudomonas and Stenotrophomonas. Various antibiotic susceptibility profiles were detected and 37% of the isolates displayed multidrug resistance (MDR). The selection of the tetA gene was confirmed by qPCR at the highest OTC concentration tested. Two MDR isolates, tested using zebrafish embryos, caused significant mortality, indicating a potential impact on fish health and survival. Overall, our work highlights the potential impact of antibiotic contamination in the selection of potential pathogenic ARB and ARGS.

scholarly journals National Antimicrobial Consumption: Analysis of Central Warehouses Supplies to In-Patient Care Health Facilities from 2017 to 2019 in Uganda

2021 ◽  
Vol 6 (2) ◽  
pp. 83
Author(s):  
Juliet Sanyu Namugambe ◽  
Alexandre Delamou ◽  
Francis Moses ◽  
Engy Ali ◽  
Veerle Hermans ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Health Facilities ◽  
World Health ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
National Medical ◽  
The World ◽  
Daily Dose ◽  
Care Health ◽  
Health Organization

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.

scholarly journals Neisseria meningitidis carriage and risk factors among teenagers in Suizhou city in China

2020 ◽  
Vol 148 ◽  
Author(s):  
Fei He ◽  
Hong mei Yang ◽  
Guo ming Li ◽  
Bing qing Zhu ◽  
Yating Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Neisseria Meningitidis ◽  
Old Age ◽  
Age Groups ◽  
Significant Risk ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Carriage Rate

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.

scholarly journals The decomposition of life expectancy for age and cause of death in Tuscany, Italy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
National Level ◽  
Age Groups ◽  
Resistant Bacteria ◽  
Mortality Data ◽  
Life Expectancy At Birth ◽  
Icd 10 ◽  
Reduction Of Mortality ◽  
The Impact

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, &lt;1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.

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