Antibiotic prescribing patterns in Italian hospital inpatients with pneumonia, chronic obstructive pulmonary disease, and urinary tract infections.
OBJECTIVE
The primary objective of this study was to describe the antibiotic prescribing patterns in hospital inpatients with pneumonia (PN), exacerbations of chronic obstructive pulmonary disease (COPD), and urinary tract infections (UTIs). A second objective was to verify if some selected variables (i.e., risk factors, patient age, size of hospitals) were affecting the therapeutic choice.


METHODS
Survey was performed on 1609 patients. The data were collected by physicians using a special form, covering a six-month period.


METHODS
Twenty-six medical wards and 8 geriatric wards in 24 acute-care hospitals in the Veneto Region in Northern Italy.


METHODS
A consecutive sample of PN, COPD, and UTI patients treated with antibiotics.


METHODS
The following information was collected: patient and hospital demographics, risk factors, diagnoses, and antibiotic regimens.


RESULTS
Sixty-three antimicrobial agents used, with 2115 administrations, 1227 of which were single-drug therapy. The most frequently used drugs were third-generation cephalosporins (24.6 percent), fluoroquinolones (15.4 percent), aminopenicillins (15.0 percent), and ureidopenicillins (9.7 percent). There is great variability of therapeutic regimens in the various hospitals for the same disease. However, this variability is not explained by the different types of hospitals or by the patients' characteristics (e.g., age, risk factors).


CONCLUSIONS
Our results show that the use of broad-spectrum antibiotics probably is excessive. Moreover, the treatment seems to be based more on the opinion of the treating physician and the local habits rather than objective criteria. These factors may have negative repercussions not only in economic terms, but also in terms of alteration of the bacterial ecology.
Guglielmo
L
L
Department of medicine, City Hospital, Cologna Veneta, Italy.
Leone
R
R
Moretti
U
U
Conforti
A
A
Spolaor
A
A
Velo
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents