阿莫西林短缺对基层医疗机构儿科抗生素处方的影响。

IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES
Federica Pagano, Giulio De Marco, Benedetta Trojano, Chiara Amato, Maria Micillo, Gaetano Cecere, Alfredo Guarino, Andrea Lo Vecchio
{"title":"阿莫西林短缺对基层医疗机构儿科抗生素处方的影响。","authors":"Federica Pagano, Giulio De Marco, Benedetta Trojano, Chiara Amato, Maria Micillo, Gaetano Cecere, Alfredo Guarino, Andrea Lo Vecchio","doi":"10.3390/antibiotics14030313","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objectives:</b> A previous study settled in the Campania Region (Southern Italy) has proven the effectiveness of a multifaceted antimicrobial stewardship program in reducing prescription rates and use of broad-spectrum molecules in the Primary Care setting. Since autumn 2022, the amoxicillin shortage has been reported at a national level, and respiratory pathogens resurged in children after the easing of COVID-19 pandemic restrictions. We aimed to assess the impact of amoxicillin shortage on antimicrobial prescription patterns and quality indexes in the same setting as the past AMS campaign. <b>Methods:</b> We conducted a retrospective review of antibiotic prescriptions in a primary care pediatric practice, focusing on amoxicillin, amoxicillin-clavulanate, third-generation cephalosporins, macrolides, and quinolones. To assess drug accessibility, we monitored antibiotic availability in pharmacies within the same healthcare district. We then analyzed monthly prescription rates per 100 consultations in relation to drug availability patterns and calculated the amoxicillin/amoxicillin-clavulanate index and the Access/Watch index as quality indicators. <b>Results:</b> From November 2022 to May 2023, 90% of the surveyed pharmacies reported an amoxicillin shortage lasting 5 to 7 months. Concomitantly, we observed a significant shift in the prescription pattern for amoxicillin-clavulanate (3.53 to 13.82; <i>p</i> = 0.009) and third-generation cephalosporins (2.45 to 4.83; <i>p</i> = 0.026), that resulted in a decline of the amoxicillin/amoxicillin-clavulanate index (1.38 to 0.56; <i>p</i> = 0.009). <b>Conclusions:</b> The lack of amoxicillin could have led to increased prescriptions of second-line antibiotics in Italian regions, reverting the effect of successful stewardship measures.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939257/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of Amoxicillin Shortage on Pediatric Antibiotic Prescriptions in Primary Care.\",\"authors\":\"Federica Pagano, Giulio De Marco, Benedetta Trojano, Chiara Amato, Maria Micillo, Gaetano Cecere, Alfredo Guarino, Andrea Lo Vecchio\",\"doi\":\"10.3390/antibiotics14030313\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background/Objectives:</b> A previous study settled in the Campania Region (Southern Italy) has proven the effectiveness of a multifaceted antimicrobial stewardship program in reducing prescription rates and use of broad-spectrum molecules in the Primary Care setting. Since autumn 2022, the amoxicillin shortage has been reported at a national level, and respiratory pathogens resurged in children after the easing of COVID-19 pandemic restrictions. We aimed to assess the impact of amoxicillin shortage on antimicrobial prescription patterns and quality indexes in the same setting as the past AMS campaign. <b>Methods:</b> We conducted a retrospective review of antibiotic prescriptions in a primary care pediatric practice, focusing on amoxicillin, amoxicillin-clavulanate, third-generation cephalosporins, macrolides, and quinolones. To assess drug accessibility, we monitored antibiotic availability in pharmacies within the same healthcare district. We then analyzed monthly prescription rates per 100 consultations in relation to drug availability patterns and calculated the amoxicillin/amoxicillin-clavulanate index and the Access/Watch index as quality indicators. <b>Results:</b> From November 2022 to May 2023, 90% of the surveyed pharmacies reported an amoxicillin shortage lasting 5 to 7 months. Concomitantly, we observed a significant shift in the prescription pattern for amoxicillin-clavulanate (3.53 to 13.82; <i>p</i> = 0.009) and third-generation cephalosporins (2.45 to 4.83; <i>p</i> = 0.026), that resulted in a decline of the amoxicillin/amoxicillin-clavulanate index (1.38 to 0.56; <i>p</i> = 0.009). <b>Conclusions:</b> The lack of amoxicillin could have led to increased prescriptions of second-line antibiotics in Italian regions, reverting the effect of successful stewardship measures.</p>\",\"PeriodicalId\":54246,\"journal\":{\"name\":\"Antibiotics-Basel\",\"volume\":\"14 3\",\"pages\":\"\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939257/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antibiotics-Basel\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/antibiotics14030313\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antibiotics-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/antibiotics14030313","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

摘要

背景/目的:之前在坎帕尼亚地区(意大利南部)进行的一项研究证明了多方面抗菌药物管理计划在降低初级保健机构处方率和广谱分子使用方面的有效性。自2022年秋季以来,阿莫西林在全国范围内出现短缺,在COVID-19大流行限制放松后,儿童呼吸道病原体再次出现。我们的目的是评估阿莫西林短缺对抗菌药物处方模式和质量指标的影响,与过去的AMS活动相同。方法:我们对一家初级保健儿科诊所的抗生素处方进行了回顾性分析,重点是阿莫西林、阿莫西林-克拉维酸酯、第三代头孢菌素、大环内酯类药物和喹诺酮类药物。为了评估药物可及性,我们监测了同一医疗保健区内药房的抗生素可得性。然后,我们分析了每月每100次咨询的处方率与药物供应模式的关系,并计算了阿莫西林/阿莫西林-克拉维酸指数和获取/观察指数作为质量指标。结果:从2022年11月至2023年5月,90%的受访药房报告阿莫西林短缺持续5 ~ 7个月。与此同时,我们观察到阿莫西林-克拉维酸盐的处方模式发生了重大变化(3.53至13.82;P = 0.009)和第三代头孢菌素(2.45 ~ 4.83;P = 0.026),导致阿莫西林/阿莫西林-克拉维酸指数下降(1.38 ~ 0.56;P = 0.009)。结论:阿莫西林的缺乏可能导致意大利地区二线抗生素处方的增加,逆转了成功管理措施的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Amoxicillin Shortage on Pediatric Antibiotic Prescriptions in Primary Care.

Background/Objectives: A previous study settled in the Campania Region (Southern Italy) has proven the effectiveness of a multifaceted antimicrobial stewardship program in reducing prescription rates and use of broad-spectrum molecules in the Primary Care setting. Since autumn 2022, the amoxicillin shortage has been reported at a national level, and respiratory pathogens resurged in children after the easing of COVID-19 pandemic restrictions. We aimed to assess the impact of amoxicillin shortage on antimicrobial prescription patterns and quality indexes in the same setting as the past AMS campaign. Methods: We conducted a retrospective review of antibiotic prescriptions in a primary care pediatric practice, focusing on amoxicillin, amoxicillin-clavulanate, third-generation cephalosporins, macrolides, and quinolones. To assess drug accessibility, we monitored antibiotic availability in pharmacies within the same healthcare district. We then analyzed monthly prescription rates per 100 consultations in relation to drug availability patterns and calculated the amoxicillin/amoxicillin-clavulanate index and the Access/Watch index as quality indicators. Results: From November 2022 to May 2023, 90% of the surveyed pharmacies reported an amoxicillin shortage lasting 5 to 7 months. Concomitantly, we observed a significant shift in the prescription pattern for amoxicillin-clavulanate (3.53 to 13.82; p = 0.009) and third-generation cephalosporins (2.45 to 4.83; p = 0.026), that resulted in a decline of the amoxicillin/amoxicillin-clavulanate index (1.38 to 0.56; p = 0.009). Conclusions: The lack of amoxicillin could have led to increased prescriptions of second-line antibiotics in Italian regions, reverting the effect of successful stewardship measures.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Antibiotics-Basel
Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
7.30
自引率
14.60%
发文量
1547
审稿时长
11 weeks
期刊介绍: Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信