Biomedical subjects

D Resi

Publications and source records attributed to D Resi.

8 recordsLinked to original sources

PubMed2006

Antibiotic treatments for children ages 0-23 months in a northern Italy region: a cohort study.

BACKGROUND: This study aims to describe the pattern of antibiotic treatments in the community for children ages 0-23 months in Emilia-Romagna (a northern Italy region) pointing out possible changes of prescribed agents when first treatments in the life of each children are compared to successive ones. MATERIALS AND METHODS: The Regional Drug Prescription and the Resident Population databases were used as data sources to study the cohort of children born between January 1 and December 31, 2000 and resident in Emilia-Romagna. RESULTS: The cumulative incidences of children with at least one treatment were 22%, 55% and 82% at 6, 12 and 24 months of age, respectively. Broad spectrum penicillins were the most prescribed antibiotic class for children at their first treatment while cephalosporins were the most prescribed class for successive treatments and when pooling all treatments. CONCLUSION: Cephalosporins and other second line antibiotics are frequently prescribed to 0 to 23-month-old residents in Emilia-Romagna even when only first treatments are considered; further research is needed to quantify inappropriateness of antibiotic prescription.

Anti-Bacterial Agents↗

PubMed2006

Delay in the treatment of pulmonary TB in a changing demographic scenario.

OBJECTIVE: To quantify patient and health care delays in the treatment of pulmonary tuberculosis (PTB) in Emilia-Romagna region, Italy, and to study the association between migration status and delay. DESIGN: All patients with symptomatic PTB, aged >15 years, who were notified in Emilia-Romagna during 2003 and were alive at time of data collection, were included. An individual form was completed for each notified patient by the local health authority officer in charge of surveillance data. RESULTS: Median patient delay, health care delay and total delay were 7, 36 and 65 days, respectively. Recent migrants (stay in Italy < or = 3 years) had the longest patient delay (16 days), while Italian patients had the longest health care delay (60 days). Migration status was independently associated with both patient and health care delay, although the direction of association changed according to which delay was considered. CONCLUSION: Public health interventions aiming to reduce delay in treatment of PTB should improve the access of recent migrants to health care and increase suspicion of TB among Italian patients. Studies on delays in treatment of TB should investigate patient delay and health care delay as distinct outcomes.

Adolescent↗

PubMed2005

Barriers to effective tuberculosis control: a qualitative study.

SETTING: Emilia Romagna region, Italy. OBJECTIVE: To explore chest and infectious disease physicians' views of barriers to effective tuberculosis (TB) control and possible solutions. DESIGN: A series of nine focus groups including a total of 49 physicians. RESULTS: Three categories of barriers to effective TB control were identified: 1) uncertainty about appropriate clinical practice in the treatment of specific sub-groups of patients, such as the elderly or immigrants; 2) organisational factors, such as the availability of diagnostic services and of sufficient resources; and 3) multiple barriers to a viable and effective TB control programme in a country with a low prevalence of TB. CONCLUSIONS: The lack of integration and coordination of health services, as well as the scarcity of dedicated TB nurses, were perceived by the participants as crucial barriers to effective TB control. As a result of this study, a regional programme was started with the goals of quantifying the need for TB nurses and developing a better network for required health services. Qualitative studies such as this can be useful in improving TB control in a low-prevalence TB country, to identify problems and increase the participation of key professionals.

Attitude of Health Personnel↗

PubMed2004

Quality of local guidelines for surgical antimicrobial prophylaxis.

Surgical antimicrobial prophylaxis (AMP) is an effective measure to prevent surgical site infections. To determine the quality and availability of local guidelines for AMP, a survey was conducted in the public hospitals of a Northern Italian region. The guidelines for "Antimicrobial Prophylaxis in Surgery" by the Scottish Intercollegiate Guidelines Network (SIGN) were used as a standard by which the quality of the local guidelines was compared. The coverage of surgical specialities by local AMP guidelines was 93.1% for hospitals where guidelines had been developed at hospital level and 47% for hospitals where guidelines had been developed by individual surgical departments. Local guidelines recommended AMP for most surgical procedures (96%), including procedures with evidence against the use of antimicrobial prophylaxis (87% of these procedures). Only 8% of all procedure-specific guidelines (PSG) recommended an incorrect timing of AMP (not administering AMP at the induction of anaesthesia), while 41% recommended an incorrect duration (additional antimicrobial doses after completion of the surgical operation). This survey showed that having written protocols at local level does not necessarily mean they comply with available scientific evidence. Thus, the quality of local guidelines needs to be improved.

Anti-Bacterial Agents↗

PubMed2003

Antibiotic prescriptions in children.

OBJECTIVES: The aim of this study was to evaluate antibiotic prescription for children in Emilia Romagna, a Northern Italian region with 414 880 people aged 1-14 years. METHODS: The regional Prescription Database of drugs reimbursed by the Italian National Health Service was used in this study. Antibiotic use was estimated as the proportion of children who received at least one prescription during the year 2000 (number of children treated per 100 inhabitants per year). To evaluate the frequency of exposure for each child, all the prescriptions given within a period shorter than 12 days were considered as a single treatment. RESULTS: In the year surveyed, 511,270 antibiotic prescriptions in 219,257 children were identified. In all, 52.9% of children received at least one antibiotic; this percentage decreased with age, ranging from 70.4% in children 1-2 years old to 35.8% in children >11 years old. Fifty-two per cent of inhabitants under the age of 15 years were treated with systemic antibiotics at least once in the year. Cephalosporins were mostly prescribed in the youngest children, while macrolides were most frequently used in children over 6 years old. In all 3.9% of children were treated with topical antibiotics. CONCLUSIONS: This study has shown that paediatric antibiotic prescription rates can be derived from analysis of regional drug and resident databases. High antibiotic usage is shown in the paediatric population of Emilia Romagna, similar to that observed in other regions of Northern Italy. Broad-spectrum antibiotics are predominantly prescribed. Comparison with prescription rates from other countries' paediatric populations suggests there is extensive antibiotic overuse in Italy. This could be associated with selection for and dissemination of antibiotic resistance. Interventions are needed to reduce consumption.

Adolescent↗

PubMed2002

Use of anti-asthmatic drugs in Italy: analysis of prescriptions in general practice in the light of guidelines for asthma treatment.

UNLABELLED: Our aim was to analyse anti-asthmatic drug utilisation in primary health care in a Northern Italian region in the light of guidelines for asthma treatment. METHODS: We collected all prescriptions for anti-asthmatic agents reimbursed in 1998 in six local health authorities (overall population: 1,909,192 inhabitants) of Emilia Romagna (Northern Italy). The asthmatic cohort was defined as the population of subjects aged 20-44 years receiving at least one prescription of an anti-asthmatic agent devoid of indications for transient respiratory diseases. In order to include routine users, the asthmatic cohort was restricted to those subjects with at least one prescription in the first quarter of 1998. Anti-asthmatic agents were classified according to their therapeutic role as follows: maintenance therapy for mild-moderate asthma (Mm); maintenance therapy for severe asthma (Ms); quick relief for mild attack (Qm) and quick relief for severe attack (Qs). RESULTS: The asthmatic cohort included 11,518 subjects; of these, 47% received only one prescription in 1998. The most frequent regimens were Mm+Qm (25%) and Qm alone (23%). Some regimens appeared not to be in accordance with international recommendations. The main reasons were lack of drugs for quick relief (36%), use of long-term beta(2)-adrenoceptor agonists (Ms drugs) without quick-relief or anti-inflammatory agents (10% of the cohort and 56% of the recipients of Ms drugs) and presence of fixed-dose combinations (27%). In 76% of the patients treated with Mm drugs (mainly inhaled steroids), the total amount of drugs prescribed over the 1-year period covered less than 150 days. CONCLUSIONS: The use of anti-asthmatic drugs in general practice in Italy does not seem to comply with the international recommendations especially with regard to the use of quick-relief agents. Active interventions to implement guidelines and monitor the choice of drug regimens are warranted.

Adult↗

PubMed2001

The therapeutic course as a measure complementary to defined daily doses when studying exposure to antibacterial agents.

OBJECTIVE: The defined daily dose (DDD) method may not provide accurate information about exposure to antibacterial agents, owing to their short-term use and the consequently high turnover of subjects. This study was addressed to evaluate whether the number of "therapeutic courses" could offer additional information. METHODS: Prescription data of antibacterial agents (ATC J01) in Ravenna, Italy (350,000 inhabitants), were studied in 1998. All the prescriptions issued within 10 days were considered as belonging to one therapeutic course (TC). The following measures were compared: DDD/1000 inhabitants/year, number of exposed subjects/1000 inhabitants/year and number of TC/1000 inhabitants/year. In order to compare the number of 10-day TCs with the number of DDDs, the latter was divided by 10 (DDD10). The intensity of drug treatment was also evaluated as the average number of DDDs per TC (therapeutic intensity). RESULTS: Sixty-one percent of the subjects received only one prescription in 1998. Among the second prescriptions, 69% were issued after a time interval greater than 21 days. The overall prevalence of use was 329 per 1000 inhabitants, the TCs were 525 per 1000 inhabitants and DDD10/1000 inhabitants/year were 470. The therapeutic intensity varied with the age classes (being lowest in the elderly) and with the individual antibiotics used. Two or more antibacterials were used within the same TC in 7% of the cases. CONCLUSION: The measures considered in this study provided different estimates of exposure to antimicrobial agents. The combined analysis of DDDs and TCs may offer a more reliable information about exposure to antimicrobial agents.

Adolescent↗

PubMedDate not supplied

Tobacco consumption and sports participation: a survey among university students in northern Italy.

Social-demographic information of a total of 1249 students attending the University of Bologna was analyzed by means of an anonymous questionnaire containing 33 questions with particular reference to tobacco smoking and sports activity. Results revealed that 31.6% of the students practise some form of sports regularly (6 hours a week or more), 40.5% occasionally (at least an hour a week for 8 months in a year) and 27.9% do not take part in any kind of sport. Significant differences were seen between those that practise sports (60.4% are non-smokers and 33.5% are habitual smokers) and those that do not (52.9% are non-smokers and 40.1% smoke habitually). The smokers who are active in sports smoke a lower mean number of cigarettes a day than the inactive group and thus belong to the category of light smokers. They also smoke fewer cigarettes on days when they take part in sports activity. As far as knowledge of health risks is concerned, 21.1% of those who practise sports obtained a score between good and excellent compared to 15.9% of those who do not. Although on the whole the results appear to show a certain influence of sports on smoking habits, the kind of study we led and the differences in the number of smokers are not sufficient to consider sports practitioners as a group not at risk for behaviour harmful to the health. Further studies are necessary to verify the cause-effect relationship between sports activity and smoking habits.

Adult↗