title: Differences in outpatient antibiotic prescription in Italy's Lombardy region.
abstract: OBJECTIVE
  We assessed the antibiotic patterns of use and geographical distribution of prevalence and consumption by age in 15 Local Health Units (LHUs) of Italy's Lombardy region.
  
  
  METHODS
  A retrospective analysis of reimbursement data for the community-dwelling population in 2005 was performed. Prescriptions reimbursed by the National Health System and consumption as defined daily doses (DDD) per 1,000 inhabitants per day (DID) were analyzed. A logistic regression was performed to evaluate the association between antibiotic drug prescription and age, gender, and LHU of residence of the population.
  
  
  RESULTS
  During 2005, a total of 3,120,851 people (34% of the population) received at least one antibiotic drug prescription. The highest prescription prevalence was observed in the 0-17 and 80 or more years age ranges (41.6 and 41.9%, respectively). Large differences were found in the prevalence rates between different LHUs (ranging from 28.7% in Milan to 39.4% in Brescia) and in DID (ranging from 12.6 DID in Sondrio to 18.9 DID in Brescia). The age and residence of the population were the main determinants of drug exposure. In particular, patients aged <18 years (odds ratio [OR] = 1.73; 95% confidence interval [CI] 1.73, 1.74), aged 65 years or older (OR = 1.64; 95% CI 1.63, 1.65), and those that live in Brescia (OR = 1.66; 95% CI 1.65, 1.66) had a statistically significant higher risk of antibiotic drug exposure.
  
  
  CONCLUSIONS
  The observed intra-regional differences underline the need for a careful monitoring with the aim to reduce antibiotic resistance and improve the rational use of drugs.
authors.affiliation: Laboratory for Quality Assessment of Geriatric Therapies and Services, Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20156 Milan, Italy. carlotta.franchi@marionegri.it
authors.forename: C
authors.initials: C
authors.lastname: Franchi
authors.forename: M
authors.initials: M
authors.lastname: Sequi
authors.forename: M
authors.initials: M
authors.lastname: Bonati
authors.forename: A
authors.initials: A
authors.lastname: Nobili
authors.forename: L
authors.initials: L
authors.lastname: Pasina
authors.forename: A
authors.initials: A
authors.lastname: Bortolotti
authors.forename: I
authors.initials: I
authors.lastname: Fortino
authors.forename: L
authors.initials: L
authors.lastname: Merlino
authors.forename: A
authors.initials: A
authors.lastname: Clavenna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010045:Outpatients; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents