Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis

Abstract

Background and objective: The increasing emergence and spread of drug-resistant pathogens resulting from inappropriate antibiotic usage have become more evident in recent years, particularly with the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Since joining the Organization for Economic Cooperation and Development (OECD), Costa Rica can now compare its healthcare system with other countries, and similarities have been noted with Italy regarding health indicators. Both nations have universal healthcare systems, covering their entire populations, and hold similar positions in the Human Development Index (HDI). Consequently, the goal is to compare antibiotic prescribing and consumption patterns to collaboratively develop strategies against bacterial resistance. Methods: In order to compare antibiotic consumption between regions, a standardized contrast was utilized, specifically using the Defined Daily Dose (DDD). An Orthogonal Contrast test was performed to test the means, followed by the application of the Student's t-test on these contrasts. This analysis aimed to assess the potential influence of regions on DDD values. Antibiotic consumption data were collected between January 2021 and December 2022 from the Local Health Authority of Naples 3 South (LHANS) in Italy and IQVIA reports in Costa Rica.Results: LHANS shows a considerable disparity in gross expenditure compared to Italy's overall expenditure, while the private sector in Costa Rica exhibits even lower gross expenditure than Italy. Antibiotic consumption in Italy exceeds that of Costa Rica, with Costa Rica's consumption amounting to 47.70% of Italy's total consumption. Additionally, LHANS exhibited a 22.43% higher gross expenditure compared to the Campania region, emphasizing the variability in antibiotic usage within the same country The results indicated no statistically significant differences in antibiotic consumption between the regions, as none of the null hypotheses were rejected. Conclusions:The study provides valuable insights into expenditure patterns and antibiotic consumption, highlighting the need for improved prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings emphasize the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.

Comparison and Analysis of Antibiotic Consumption in Two Italian Hospital Settings in Relation to the Fight of Antimicrobial Resistance

“…Projections on a broader scale indicate an upsurge in deaths due to infectious diseases in the absence of viable therapeutic alternatives, creating a critical scenario with limited means to counteract. In response, the Campania Region has implemented multiple actions, including the creation of new territorial organizations for physicians through the Territorial Functional Aggregation (TFA), aiming to establish a network among physicians for therapeutic continuity and continuous training [18][19][20]. This study delves into antibiotic usage in hospital departments, evaluating consumption rates through standardized parameters and indicators based on dispensed DDDs.…”