Juliette Gagliardi
Junior Researcher
Antibiotic use in Italy - Statistics & Facts
Antibiotics are a type of drug used to fight infections caused by bacteria in humans and animals. In 1928, professor of bacteriology Alexander Fleming discovered the first antibiotic, penicillin, and since then, many other types of antibiotics have been introduced for medical use. Although antibiotics can save lives and their discovery was a revolution in the medical field contributing to lowering mortality rates, they also accelerate the natural development of bacteria resistance to antibiotics, putting at risk achievements obtained by their introduction. In 2019, the estimated number of deaths associated with bacterial antimicrobial resistance in Italy, amounted to almost 36 thousand. Furthermore, deaths directly attributable to bacterial antimicrobial resistance totaled roughly nine thousand. In both cases, Escherichia coli (E. coli) was the deadliest pathogen. Bacteremia, defined as the presence of bacteria in the bloodstream, is one of the infections that can become extremely difficult to cure and potentially fatal in case of infection due to bacteria resistant to antibiotics. In Italy, the number of bacteremia cases caused by antibiotic resistant bacteria amounted to 2,192 in 2021, most of which occurred in men.
Antibiotic consumption and cost
Between March 2021 and March 2022, around 27 percent of Italians took antibiotics orally. Although this percentage stands above the European average of 23 percent, the consumption of antibiotics in Italy has decreased over the last decade, with a shift in the use of antibiotics for systemic use from 30.2 daily defined doses (DDD) per 1,000 inhabitants per day in 2011 to 18.2 in 2021. The most consumed antibiotic in Italy was amoxicillin, with 4.5 DDD per 1,000 inhabitants per day, followed by azithromycin and clarithromycin. The average cost of antibiotics in Italy stands at 2.34 euros per DDD. Although amoxicillin was the second cheapest antibiotic in 2021, with a cost of 1.32 euros per DDD, it was the antibiotic with the highest per capita expenditure in Italy.Habits and knowledge of antibiotics
Even though viral infections cannot be fought with the use of antibiotics, during the COVID-19 pandemic the consumption of azithromycin, an antibiotic usually used against pneumonia, doubled. Observing this irrational increase in the use of this antibiotic, the AIFA (Agenzia Italiana del Farmaco – Italian pharmaceutical agency) discouraged doctors from prescribing azithromycin against COVID-19 infections. However, in many cases the doctors’ behavior did not change. This is quite alarming given that most Italians get information about unnecessary use of antibiotics mostly from doctors.
