Antibiotic use and associated factors in a large sample of hospitalised older people

6533b836fe1ef96bd12a0b47

RESEARCH PRODUCT

Antibiotic use and associated factors in a large sample of hospitalised older people

I Ardoino Pm Mannucci A Nobili C Franchi Pm Mannucci A Nobili M Tettamanti L Pasina C Franchi S Corrao A Marengoni F Salerno M Cesari F Perticone G Licata F Violi Gr Corazza D Prisco E Silvestri G Emmi A Bettiol C Caterina G Biolo M Zanetti M Guadagni M Zaccari M Chiuch M Zaccari M Vanoli G Grignani Ea Pulixi M Bernardi Sl Bassi L Santi G Zaccherini G Lupattelli E Mannarino V Bianconi F Paciullo R Alcidi R Nuti R Valenti M Ruvio S Cappelli A Palazzuoli D Girelli F Busti G Marchi M Barbagallo L Dominguez F Cocita V Beneduce L Plances S Corrao G Natoli S Mularo M Raspanti F Cavallaro M Zoli I Lazzari M Brunori E Fabbri D Magalotti R Arn?Fl Pasini Pl Capecchi G Palasciano Me Modeo C Di Gennaro Md Cappellini D Maira V Di Stefano G Fabio S Seghezzi M Mancarella Mm De Amicis G De Luca N Scaramellini M Cesari Pd Rossi S Damanti M Clerici F Conti G Bonini Bb Ottolini A Di Sabatino E Miceli Mv Lenti M Pisati Cc Dominioni G Murialdo A Marra F Cattaneo R Pontremoli V Beccati G Nobili Mb Secchi D Ghelfi L Anastasio L Sofia M Carbone L Anastasio L Sofia M Carbone F Cipollone Mt Guagnano E Valeriani I Rossi G Mancuso D Calipari M Bartone G Delitala M Berria C Pes A Delitala M Muscaritoli A Molfino E Petrillo G Zuccal?G D'aurizio G Romanelli A Marengoni A Zucchelli F Manzoni A Volpini A Picardi Uv Gentilucci P Gallo C Dell'unto G Annoni M Corsi G Bellelli S Zazzetta P Mazzola H Szabo A Bonfanti F Arturi E Succurro M Rubino B Tassone G Sesti Mg Serra Ma Bleve L Gasbarrone Mr Sajeva A Brucato S Ghidoni F Fabris I Bertozzi G Bogoni Mv Rabuini E Cosi P Scarinzi A Amabile E Omenetto T Prandini R Manfredini F Fabbian B Boari A De Giorgi R Tiseo R De Giorgio G Paolisso Mr Rizzo C Borghi E Strocchi E Ianniello M Soldati C Sabb?Fs Vella P Suppressa P Agosti A Schilardi F Loparco Gm De Vincenzo A Comitangelo E Amoruso L Fenoglio A Falcetta C Bracco Al Fracanzani S Fargion S Tiraboschi A Cespiati G Oberti G Sigon F Peyvandi R Rossio B Ferrari G Colombo V Monzani V Savojardo C Folli G Ceriani F Salerno G Pallini F Dallegri L Ottonello L Liberale L Caserza K Salam Nl Liberato T Tognin Gb Bianchi S Giaquinto F Purrello A Di Pino S Piro R Rozzini L Falanga E Spazzini C Ferrandina G Montrucchio P Petitti P Peasso E Favale C Poletto R Salmi P Gaudenzi F Violi L Perri R Landolfi M Montalto A Mirijello L Guasti L Castiglioni A Maresca A Squizzato L Campiotti A Grossi M Bertolotti C Mussi G Lancellotti Mv Libbra G Dondi E Pellegrini L Carulli M Galassi Y Grassi F Perticone M Perticone R Battaglia M Filice R Maio V Stanghellini E Ruggeri S Del Vecchio A Salvi R Leonardi G Damiani W Capeci A Gabrielli M Mattioli Gp Martino L Biondi P Pettinari R Ghio A Dal Col S Minisola L Colangelo M Cilli G Labbadia A Afeltra B Marigliano Me Pipita P Castellino L Zanoli S Pignataro A Gennaro J Blanco V Saracco M Fogliati C Bussolino F Mete M Gino A Cittadini C Vigorito M Arcopinto A Salzano E Bobbio Am Marra D Sirico G Moreo F Gasparini S Prolo G Pina A Ballestrero F Ferrando S Berra S Dassi Mc Nava B Graziella S Baldassarre S Fragapani G Gruden G Galanti G Mascherini C Petri L Stefani M Girino V Piccinelli F Nasso V Gioffr?M Pasquale G Scattolin S Martinelli M Turrin L Sechi C Catena G Colussi N Passariello L Rinaldi F Berti G Famularo P Tarsitani R Castello M Pasino Gp Ceda Mg Maggio S Morganti A Artoni S Del Giacco D Firinu F Losa G Paoletti G Costanzo G Montalto A Licata V Malerba Fa Montalto A Lasco G Basile A Catalano L Malatino B Stancanelli V Terranova S Di Marca R Di Quattro L La Malfa R Caruso P Mecocci C Ruggiero V Boccardi T Meschi F Lauretani A Ticinesi A Nouvenne P Minuz L Fondrieschi M Pirisi Gp Fra D Sola M Porta P Riva R Quadri E Larovere M Novelli G Scanzi C Mengoli S Provini L Ricevuti E Simeone R Scurti F Tolloso R Tarquini A Valoriani S Dolenti G Vannini A Tedeschi L Trotta R Volpi P Bocchi A Vignali S Harari C Lonati M Cattaneo Rd Nieves Mm Alberto Ar Pedro Lp Vanessa T Lara Cv Xavier F Francesc Dm Jesus Bt Esperanza Dcb Esther Sp Maria M Romero Pl Blanca Lgc Cristina Vgm Victoria L Saez J Bosco Sb Susana Ag Marta Gb Concepcion Fm Antonio Mg Hernandez Mp Borrego Pc Raquel Pr Florencia Go Beatriz Cg Sara Gcc Alfonso Pm Marta Rc Alberto Aa Antonio Gg Montserrat Brm Angel Mj Manuel Nv Ignacio As Lucia L Alfonso Rb David Vi Iniguez Rp Monica

subject

Registrie Male 0301 basic medicine Antibiotics Logistic regression 0302 clinical medicine Drug Prescription 80 and over Prevalence Immunology and Allergy LS4_4 Hospital Mortality Registries 030212 general & internal medicine Multivariate Analysi Respiratory Tract Infections Aged 80 and over Anti-Bacterial Agents Hospitalization Italy Antibiotic use Female Human Microbiology (medical)medicine.medical_specialty Logistic Model Internal medicine ward medicine.drug_class 030106 microbiology Immunology Socio-culturale Drug Prescriptions Microbiology Odds 03 medical and health sciences Antibiotic resistance Anti-Bacterial Agent medicine Antibiotic use; Internal medicine ward; Older people; Aged; Aged 80 and over; Anti-Bacterial Agents; Drug Prescriptions; Female; Geriatric Assessment; Hospital Mortality; Hospitalization; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Prevalence; Registries; Respiratory Tract Infections Humans Medical prescription Antibiotic use Geriatric Assessment Aged business.industry Confidence interval Logistic Models Antibiotic use Internal medicine ward Older people Multivariate Analysis Emergency medicine Older people Older people business Antibiotic use; Internal medicine ward; Older people

description

Objectives: The aims of this study were to assess (i) the prevalence of antibiotic use, (ii) factors associated with their use and (iii) the association with in-hospital mortality in a large sample of hospitalised older people in Italy.Methods: Data were obtained from the 2010-2017 REPOSI register held in more than 100 internal medicine and geriatric wards in Italy. Patients aged >= 65 years with at least one antibiotic prescription during their hospitalisation were selected. Multivariable logistic regression models were used to determine factors associated with antibiotic use.Results: A total of 5442 older patients were included in the analysis, of whom 2786 (51.2%) were prescribed antibiotics during their hospitalisation. The most frequently prescribed antibiotic class was beta-lactams, accounting for 50% of the total prescriptions. Poor physical independence, corticosteroid use and being hospitalised in Northern Italy were factors associated with a higher likelihood of being prescribed antibiotics. Antibiotic use was associated with an increased risk of in-hospital mortality (odds ratio = 2.52, 95% confidence interval 1.82-3.48) also when accounting for factors associated with their use.Conclusion: Hospitalised older people are often prescribed antibiotics. Factors related to poor physical independence and corticosteroid use are associated with increased antibiotic use. Being prescribed antibiotics is also associated with an increased risk of in-hospital death. These results demand the implementation of specific stewardship programmes to improve the correct use of antibiotics in hospital settings and to reduce the risk of antimicrobial resistance. (C) 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.

year	journal	country	edition	language
2019-01-01	Journal of Global Antimicrobial Resistance

https://doi.org/10.1016/j.jgar.2019.04.013