The National Report on Antibiotics Use in Italy - 2019 provides data and analyses on trends in consumption and expenditure for antibiotics for human use in Italy.

“This Report – commented Director General Nicola Magrini – is a special chapter of AIFA’s OsMed series. Antibiotic resistance is one of the major global health emergencies, and in some countries, it has reached worrying levels. Italy is still among the largest users of antibiotics in Europe, and is one of the countries recording the worst results in terms of antibiotic resistance in the hospital setting. The weak signs of contraction in antibiotics use in recent years are not enough. To have a positive impact on antibiotic resistance, a drastic reduction of at least 50% is necessary. To this end, a more effective approach needs to be adopted compared to the past. AIFA is aware of this and will set up an ad hoc working group within the Emergency Crisis Unit”.

• In 2019 the use of antibiotics in Italy remained unchanged compared to 2018 (21.4 DDD/1000 inhab. per day), reaching levels above the European average
• A considerable regional variability was confirmed, with higher values observed in the South compared with Central and Northern Italy
• Differences in use related to the number of prescriptions and to the type of antibiotics prescribed (type of molecule; broad vs. narrow spectrum)
• Regional variability and wide seasonal fluctuation in consumption suggested that use was not always appropriate
• The consumption of fluoroquinolones continued to decrease, although areas of inappropriate use still remained
• The combination amoxicillin/clavulanic acid was the most widely used antibiotic. An over-use compared with amoxicillin alone was likely, particularly in the paediatrics
• In the three-year period 2016-2019, outpatient setting use (antibiotics provided by public and private pharmacies) decreased by 5.8%, below the target set by the National antibiotic resistance Plan (PNCAR) for 2020 (reduction > 10 %)
• During the same three-year period, inpatient consumption grew despite a slight reduction observed in the last year, while the PNCAR target for 2020 was a reduction of > 5 %.

The Report includes a focus on the use of antibiotics in the paediatric population and on the prescription of fluoroquinolones in specific population subsets, analyses of the inpatient use and private purchases of class A antibiotics (reimbursed by the National Health System), a comparison with other European countries, and an overview of regional initiatives to promote the appropriate use of these medicines. A comparison is also provided between consumption in the first half of 2020 and the corresponding period in 2019, in order to assess the impact of the COVID-19 epidemic.

Giovanni Rezza (Ministry of Health), Antonietta Cavallo (Ministry of Economics and Finance), Nicola Magrini, Francesco Trotta, Giuseppe Traversa, Filomena Fortinguerra and Agnese Cangini (AIFA), Roberto Da Cas (National Health Institute - ISS), Evelina Tacconelli (University of Verona), Anna Maria Marata (Emilia Romagna Region) took part in the presentation.

To view the presentation: https://youtu.be/Egzd9Tf0tEc

The Report is available (in Italian) at: https://www.aifa.gov.it/-/l-uso-degli-antibiotici-in-italia-rapporto-nazionale-anno-2019