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Antibiotic and anti-asthmatic drug prescriptions in Italy: geographic patterns and socio-economic determinants at the district level

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

To analyse the prevalence rate of antibiotics and anti-asthmatics in children and adolescents at the healthcare district level.

Methods

Data sources were three regional prescription databases. A total of 175 healthcare districts (3.3 million children/adolescents) participated in the study, providing data for the year 2008. Prevalence rate was standardised by age. The ANOVA test was used to compare prevalence rates of districts in the three regions. The standardised prevalence ratio (SPR) was calculated for each district and a map of the index was elaborated. The correlation among latitude, average annual income per inhabitant, hospitalisation rate, number of paediatricians per 1,000 resident children and prevalence rate was evaluated by district (Spearman’s test).

Results

The antibiotic prevalence rate was, on average, 47.9 % (34.0 to 67.9 % between districts), while the anti-asthmatic prevalence was 21.4 % (11.7−35.6 %). The prevalence was higher in districts from the southern regions (antibiotics F = 92.1, anti-asthmatics F = 107.5; p < 0.001). There was a significant correlation between the prevalence of antibiotics and anti-asthmatics (rS = 0.77 p < 0.001), and the prevalence of both was inversely related to latitude (respectively rS = −0.71, −0.72; p < 0.001) and average income (rS = −0.77, −0.73; p < 0.001). Children/adolescents living in districts in the lower quintile of average income were more exposed to antibiotic (OR = 1.75; 1.74–1.77) and anti-asthmatic (OR 1.56, 1.55–1.57) prescriptions.

Conclusions

A lower income at the district level is related to higher antibiotic and anti-asthmatic drug prescription rates. Local socio-economic inequities can concur in prescribing distribution and must be considered when planning educational interventions to reduce over-prescription.

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Acknowledgements

We are grateful to Chiara Pandolfini for language editing.

Contributions of authors statement

All the authors contributed equally to the design of the study. DP collected the data, undertook the statistical analysis and wrote the first draft of the manuscript. AC contributed to the planning of the data analysis and writing of the manuscript. AC and MB supervised the study. All authors contributed to and have approved the final manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Public Health, Laboratory for Mother and Child Health, IRCCS—Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156, Milan, Italy

    Daniele Piovani, Antonio Clavenna, Massimo Cartabia & Maurizio Bonati

Authors
  1. Daniele Piovani
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  2. Antonio Clavenna
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  3. Massimo Cartabia
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  4. Maurizio Bonati
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on behalf of the Interregional Italian Drug Utilisation Group

Corresponding author

Correspondence to Daniele Piovani.

Additional information

Interregional Italian Drug Utilisation Group:

Lombardy Region: Angela Bortolotti, Ida Fortino, Luca Merlino

Lazio Region: Marina Davoli, Ursula Kirchmayer

Puglia Region: Ambrogio Aquilino, Francesco Bux

Department of ClinicalPharmacology and Epidemiology, Consorzio Mario Negri Sud: Antonio D’Ettorre, Vito Lepore

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Piovani, D., Clavenna, A., Cartabia, M. et al. Antibiotic and anti-asthmatic drug prescriptions in Italy: geographic patterns and socio-economic determinants at the district level. Eur J Clin Pharmacol 70, 331–337 (2014). https://doi.org/10.1007/s00228-013-1615-4

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  • DOI: https://doi.org/10.1007/s00228-013-1615-4

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