PHP101 - SOCIO-ECONOMIC AND SOCIO-DEMOGRAPHIC DRIVERS INFLUENCING PREVALENCE OF ANTIBIOTIC USE: AN ANALYSIS IN SOUTHERN ITALY SETTING

Abstract

To analyze the geographic variation in systemic antibiotic prescription at a regional level and to explore the influence of socioeconomic and sociodemographic variables. Retrospective analysis of reimbursement pharmacy records in the outpatient settings of Italy’s Campania Region in 2016. Standardized antibiotic prescription rates were calculated at municipality and Local Health Unit (LHU) level. Antibiotic consumption was analyzed as DDD/1000 inhabitants per day. Average antibiotic prevalence rate was 46.8%. At LHU level, the age-adjusted prevalence rates ranged from 41.1% in Benevento to 51.0% in Naples2. Significant differences were found among municipalities: from 15.2% in Omignano (Sa-LHU) to 61.9% in Moschiano (Av-LHU). The geographic distribution also showed significant differences in terms of antibiotic consumption: from 6.7 DDD/1000 inhabitants/day in Omignano to 41.6 in San Marcelino (Ce-LHU). Logistic regression showed that both municipality type and average annual income level were the main determinants of antibiotic prescription. Urban municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to rural municipalities [adjusted OR: 8.62 (95%CI: 4.06 – 18.30, P < 0.001)]. Municipalities with low average annual income level were more than eight times as likely to have antibiotic high prevalence rates compared to high average annual income level municipalities [adjusted OR: 8.48 (95%CI: 3.45 – 20.81, P < 0.001)]. We provide a snapshot of Campania’s antibiotic consumption, evidencing the impact of both socioeconomic and sociodemographic factors on the prevalence of antibiotic prescription. The observed intraregional variability underlines the lack of shared therapeutic protocols and the need of a careful monitoring. Our results can be useful for decision-makers to plan educational interventions, thus optimizing health resources and improving rational drug use.