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

被引：7

作者：

Ardoino, I ^{[1
]}

Mannucci, P. M. ^{[2
]}

Nobili, A. ^{[1
]}

Franchi, C. ^{[1
]}

Mannucci, Pier Mannuccio

Nobili, Alessandro

Tettamanti, Mauro

Pasina, Luca

Franchi, Carlotta

Corrao, Salvatore ^{[1
,11
]}

Marengoni, Alessandra ^{[26
]}

Salerno, Francesco ^{[41
,42
]}

Cesari, Matteo ^{[16
]}

Perticone, Francesco ^{[55
]}

Licata, Giuseppe

Violi, Francesco ^{[50
]}

Corazza, Gino Roberto

Prisco, Domenico ^{[3
]}

Silvestri, Elena ^{[3
]}

Emmi, Giacomo ^{[3
]}

Bettiol, Alessandra ^{[3
]}

Caterina, Cenci ^{[3
]}

Biolo, Gianni ^{[4
]}

Zanetti, Michela ^{[4
]}

Guadagni, Martina ^{[4
]}

Zaccari, Michele ^{[4
]}

Chiuch, Massimiliano ^{[4
]}

Zaccari, Michele ^{[4
]}

Vanoli, Massimo ^{[5
]}

Grignani, Giulia ^{[5
]}

Pulixi, Edoardo Alessandro ^{[5
]}

Bernardi, Mauro ^{[6
]}

Bassi, Silvia Li ^{[6
]}

Santi, Luca ^{[6
]}

Zaccherini, Giacomo ^{[6
]}

Lupattelli, Graziana ^{[7
]}

Mannarino, Elmo ^{[7
]}

Bianconi, Vanessa ^{[7
]}

Paciullo, Francesco ^{[7
]}

Alcidi, Riccardo ^{[7
]}

Nuti, Ranuccio ^{[8
]}

Valenti, Roberto ^{[8
]}

Ruvio, Martina ^{[8
]}

Cappelli, Silvia ^{[8
]}

Palazzuoli, Alberto ^{[8
]}

Girelli, Domenico ^{[9
]}

Busti, Fabiana ^{[9
]}

Marchi, Giacomo ^{[9
]}

Barbagallo, Mario ^{[10
]}

Dominguez, Ligia ^{[10
]}

机构：

[1] IRCCS, Dept Neurosci, Ist Ric Farmacol Mario Negri, Milan, Italy

[2] Fdn IRCCS CaGranda, Osped Maggiore Policlin, Sci Direct, Milan, Italy

[3] Azienda Osped Univ Careggi Firenze, Med Interna Interdisciplinare, Florence, Italy

[4] Azienda Sanitaria Univ Integrata Trieste, Clin Med Gen & Terapia Med, Trieste, Italy

[5] Osped Merate, Azienda Osped Prov Lecco, Med Interna, Lecce, Italy

[6] Azienda Osped Policlin St Orsola Malpighi, Semeiot Med Bernardi, Bologna, Italy

[7] Azienda Osped Santa Maria Misericordia, Med Interna, Perugia, Italy

[8] Azienda Osped Univ Senese, Med Interna 1, Siena, Italy

[9] Azienda Osped Univ Integrata Verona, Med Gen & Malattie Aterotrombot Degenerat, Verona, Italy

[10] Azienda Osped Univ, Policlin Giaccone, Policlin Palermo, Unita Operat Geriatria & Lungodegenza, Palermo, Italy

[11] UOC Med Interna Indirizzo Geriatr Riabilitat, ARNAS Civ, Palermo, Italy

[12] Azienda Osped Univ, Policlin S Orsola Malpighi, Unita Operat Med Interna, Bologna, Italy

[13] Azienda Osped Univ Senese, Unita Operat Complessa Med 2, Siena, Italy

[14] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Osped L DAgostino, Med Interna Univ A Murri, Bari, Italy

[15] Osped Maggiore Policlin, Unita Operat Med Interna IA, Fdn IRCCS Ca Granda, Milan, Italy

[16] Osped Maggiore Policlin, Geriatria, Fdn IRCCS Ca Granda, Milan, Italy

[17] IRCCS Policlin San Matteo Pavia, Clin Med 1, Reparto 11, Pavia, Italy

[18] IRCCS Azienda Osped Univ San Martino IST Genova, Clin Med Interna 2, Genoa, Italy

[19] Osped Bassini Cinisello Balsamo, Div Med, Milan, Italy

[20] Osped Civile Jazzolino Vibo Valentia, Med Interna, Vibo Valentia, Italy

[21] Osped Clinicizzato SS, Clin Med, Chieti, Italy

[22] Osped Giovanni Paolo II Lamezia Terme, Unita Operat Complessa Med Interna, Catanzaro, Italy

[23] Azienda Osped Univ Sassari, Clin Med, Sassari, Italy

[24] Sapienza Univ Roma, Policlin Umberto I, Med Interna & Nutr Clin Policlin Umberto I, Rome, Italy

[25] Policlin Univ A Gemelli, Unita Operat Complessa Med Urgenza & Pronto Socco, Rome, Italy

[26] Spedali Civili Brescia, Geriatr, Brescia, Italy

[27] Univ Campus Biomed, Med Clin Epatol, Rome, Italy

[28] Univ Milano Bicocca, Osped S Gerardo, Unita Operat Geriatria, Monza, Italy

[29] Univ Magna Grecia, Policlin Mater Domini, Unita Operat Complessa Med Interna, Catanzaro, Italy

[30] Azienda Osped Cardinale Panico Tricase, Unita Operat Complessa Med, Lecce, Italy

[31] Azienda Osped Osped San Camillo Forlanini, Med Interna 1, Rome, Italy

[32] Azienda Osped Papa Giovanni XXIII, Med 1, Bergamo, Italy

[33] Azienda Osped Univ Padova, Clin Med 1, Padua, Italy

[34] Azienda Osped Univ St Anna, Unita Operat Clin Med, Ferrara, Italy

[35] Seconda Univ Studi Napoli, Azienda Osped Univ, Div Med Interna & Malattie Nutr Invecchiamento 4, Naples, Italy

[36] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Univ C Frugoni, Bari, Italy

[37] Azienda Sanit Osped Santa Croce & Carle Cunco, SC Med Interna, Cuneo, Italy

[38] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna 1B, Milan, Italy

[39] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, UOC Med Gen Emostatsi & Trombosi, Milan, Italy

[40] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna Alta Intens, Milan, Italy

[41] IRCCS Policlin San Donato, Milan, Italy

[42] Univ Milan, Med Interna, Milan, Italy

[43] Univ Genoa, Med Interna 1, Genoa, Italy

[44] Osped Casorate Primo, ASST Pavia, UOSD Med Interna, Pavia, Italy

[45] Azienda Osped Bolognini Seriate, Osped SS Gerosa& Capitanio Lovere, Unita Operat Complessa Med Gen, Bergamo, Italy

[46] Osped Garibaldi Nesima, Unita Operat Complessa Med Interna, Catania, Italy

[47] Osped Poliambulanza, Med Interna & Geriatira, Brescia, Italy

[48] Univ Torino, Dipartimento Sci Med, Citta Sci & Salute, Med Interna U Indirizzo Urgenza 2, Turin, Italy

[49] Azienda Osped Univ S Anna, Unita Operat Med Osped 2, Ferrara, Italy

[50] Policlin Umberto 1, Prima Clin Med, Rome, Italy

来源：

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE | 2019年 / 19卷

关键词：

Antibiotic use; Internal medicine ward; Older people; POLYPHARMACY; OUTCOMES;

D O I：

10.1016/j.jgar.2019.04.013

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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.

引用

页码：167 / 172

页数：6

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