title: Comparison of sales and reimbursement data regarding outpatient antibiotic use in a northern Italian Region.
abstract: OBJECTIVE
  To evaluate the accuracy of systemic antibiotic use statistics, based on the reimbursement data of the Emilia-Romagna Region (Italy), focusing on agents prescribed for urinary tract infections.
  
  
  METHODS
  Reimbursement data were obtained from the drug prescription database that includes all outpatient drug prescriptions reimbursed by the Regional Health Service in 2007. Reimbursements were compared to sales data, provided by International Medical Statistics (IMS) Health.
  
  
  RESULTS
  The reimbursement data of the Emilia-Romagna Region significantly underestimates the actual use of systemic antibiotics when compared to sales. The overall underestimation of antibiotic use is 19%, ranging from 7% for second-third-generation cephalosporins to 98% for nitrofurantoin. Considering agents prescribed for urinary tract infections (UTIs), use of nitrofurantoin and sulfamethoxazole-trimethoprim are more underestimated while fluoroquinolones and fosfomycin are less underestimated than the average for systemic antibiotics.
  
  
  CONCLUSIONS
  Sales data from community pharmacies are important for accurate estimation of systemic antibiotic use in Emilia-Romagna especially for agents, such as nitrofurantoin, purchased without reimbursement in most cases.
authors.affiliation: Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regionale Emilia-Romagna, Bologna, Italy. cgagliotti@regione.emilia-romagna.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Gagliotti
authors.forename: Ilaria
authors.initials: I
authors.lastname: Mazzetti
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Moro
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D007558:Italy; D008389:Marketing of Health Services / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents