The prescription of antimicrobials by general practitioners: the differences between north and south Italian provinces

Background: Antimicrobials resistance (AMR) is an increasingly serious global health problem, both in terms of clinical implications and economic expenditure. In Italy, there are differences in prescribing rates between regions. We aimed to compare these differences in two Italian provinces: one of Emilia Romagna (north region) and one of Puglia (south region). Methods: The number of antibiotics prescribed packages and the relative expenditure data (year 2015) were obtained. We applied the prescription quality indicators proposed by the European Surveillance of Antimicrobial Consumption for an in-depth analysis. Results: Both consumption and expenditure were higher in the south province. In the Apulian province also the use of parenteral antibiotics was more frequent. The most prescribed antibiotics in both the provinces were: penicillins (combined or not), macrolides, and fluoroquinolones. Conclusion: We observed variability between the north and south province in terms of antibiotics prescription. Overall, our study indicates that antibacterials could be overprescribed. The choice of the right antibiotic continues to be a demanding task for practitioners and much still needs to be done in the fight against AMR, starting from a more appropriate use and interventions aimed at raising awareness of antibiotic resistance.