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Ferrara F, Castagna T, Pantolini B, Campanardi MC, Roperti M, Grotto A, Fattori M, Dal Maso L, Carrara F, Zambarbieri G, Zovi A, Capuozzo M, Langella R. The challenge of antimicrobial resistance (AMR): current status and future prospects. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03318-x. [PMID: 39052061 DOI: 10.1007/s00210-024-03318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
Antimicrobial resistance (AMR) represents a critical global threat, compromising the effectiveness of antibacterial drugs as bacteria adapt and survive exposure to many classes of these drugs. This phenomenon is primarily fueled by the widespread overuse and misuse of antibacterial drugs, exerting selective pressure on bacteria and promoting the emergence of multi-resistant strains. AMR poses a top-priority challenge to public health due to its widespread epidemiological and economic implications, exacerbated not only by the diminishing effectiveness of currently available antimicrobial agents but also by the limited development of genuinely effective new molecules. In addressing this issue, our research aimed to examine the scientific literature narrating the Italian situation in the common European context of combating AMR. We sought to delineate the current state of AMR and explore future prospects through an analysis of strategies to counter antibacterial drug resistance. Adopting the "One Health" model, our objective was to comprehensively engage diverse sectors, integrate various disciplines, and propose programs, policies, and regulations. This narrative review, based on PubMed research related to antibiotic resistance, emphasizes the urgent need for a coordinated and proactive approach at both national and European levels to mitigate the impact of AMR and pave the way for effective strategies to counter this global health challenge.
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Affiliation(s)
- Francesco Ferrara
- Pharmaceutical Department, Asl Napoli 3 Sud, Dell'amicizia Street 72, 80035, Nola, Naples, Italy.
| | - Tommaso Castagna
- Pharmacy Unit, ASST Di Lecco, Dell'Eremo Street 9/11, 23900, Lecco, Italy
| | | | | | - Martina Roperti
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, 20159, Milan, Italy
| | - Alessandra Grotto
- University of Milan, Festa del Perdono Street 7, 20122, Milan, Italy
| | - Martina Fattori
- Istituto Europeo Di Oncologia, Ripamonti Street 435, 20122, Milan, Italy
| | - Lucia Dal Maso
- Pharmaceutical Department, ASST Santi Paolo E Carlo, Antonio Rudinì Street 8, 20159, Milan, Italy
| | - Federica Carrara
- Pharmaceutical Department, Humanitas Gavazzeni, Mauro Gavazzeni Street 21, 24125, Bergamo, BG, Italy
| | - Giulia Zambarbieri
- Pharmaceutical Department, Humanitas Gavazzeni, Mauro Gavazzeni Street 21, 24125, Bergamo, BG, Italy
| | - Andrea Zovi
- Ministry of Health, Viale Giorgio Ribotta 5, 00144, Rome, Italy
| | - Maurizio Capuozzo
- Pharmaceutical Department, Asl Napoli 3 Sud, Dell'amicizia Street 72, 80035, Nola, Naples, Italy
| | - Roberto Langella
- Italian Society of Hospital Pharmacy (SIFO), SIFO Secretariat of the Lombardy Region, Via Carlo Farini, 81, 20159, Milan, Italy
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Ferrara F, Capuozzo M, Langella R, Trama U, Nava E, Ottaiano A, Zovi A. Analysis of biosimilars consumption in an Italian Local Health Authority. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:5317-5323. [PMID: 38231416 DOI: 10.1007/s00210-024-02951-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/10/2024] [Indexed: 01/18/2024]
Abstract
Biosimilar drugs offer an opportunity for all global healthcare systems because they provide significant cost savings while ensuring equal efficacy and safety in the treatment of chronic diseases. These savings can be allocated to support ongoing innovation. An analysis of the usage of major biosimilar drugs across various therapeutic areas has been conducted within an Italian healthcare company serving a population of over one million. Data on consumption, expenditure, and the number of treated patients has been extracted from the company's databases. Finally, a comparison with the year 2021 has been performed to determine if biosimilar drug usage increased in 2022. In 2022, the data reveals that a substantial portion of the analysed active ingredients are being used as biosimilar drugs, except in a few residual cases. However, among the most consumed drugs, resistance still exists in the case of Adalimumab and Etanercept, for which expenditure on originator drugs exceeds 2 million euros. The 2022-2021 comparison highlights the increasing use of biosimilar drugs. This data is encouraging and suggests that in the coming months, we may achieve total utilization, which would be to the benefit of the National Healthcare System (NHS) and the citizens who can rely on an efficient and sustainable healthcare policy that is continually improving.
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Affiliation(s)
- Francesco Ferrara
- Pharmacy Department, Asl Napoli 3 Sud, Dell'amicizia Street 22, 80035, Naples, Nola, Italy.
| | - Maurizio Capuozzo
- Pharmaceutical Department, Asl Napoli 3 Sud, Marittima Street 3, 80056, Ercolano, Naples, Italy
| | - Roberto Langella
- Italian Society of Hospital Pharmacy (SIFO), SIFO Secretariat of the Lombardy Region, Via Carlo Farini, 81, 20159, Milan, Italy
| | - Ugo Trama
- General Direction for Health Protection and Coordination of the Campania Regional Health System, Naples, Italy
| | - Eduardo Nava
- Pharmacy Department, Asl Napoli 3 Sud, Dell'amicizia Street 22, 80035, Naples, Nola, Italy
| | - Alessandro Ottaiano
- Istituto Nazionale Tumori Di Napoli, IRCCS "G. Pascale," Via M. Semmola, 80131, Naples, Italy
| | - Andrea Zovi
- Ministry of Health, Viale Giorgio Ribotta 5, 00144, Rome, Italy
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Ferrara F, Pasquinucci R, Capuozzo M, Polito G, Bagaglini G, Vaccaro M, Coluccia A, Langella R, Trama U, Nava E, Zovi A. Comparison and Analysis of Antibiotic Consumption in Two Italian Hospital Settings in Relation to the Fight of Antimicrobial Resistance. Pharmaceuticals (Basel) 2024; 17:183. [PMID: 38399398 PMCID: PMC10893110 DOI: 10.3390/ph17020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024] Open
Abstract
Introduction: The emergence and spread of drug-resistant pathogens due to the improper use of antibiotics have become increasingly apparent in recent years. Objective: This retrospective comparative analysis aimed to assess and compare antibiotic prescription trends in Italy across two different regions based on geographic area and healthcare structure. One region represents a large hospital institution, while the other represents a populous local Italian health agency. The study also examined the impact of documented antibiotic stewardship programs and efforts to promote responsible antibiotic use at all levels, in alignment with international goals. Antibiotic consumption data were collected from the Umberto I Polyclinic Hospital and the ASL Napoli 3 South Local Health Agency. Methods: To compare consumption between regions, a standardized comparison using the Defined Daily Dose (DDD) was employed. The internal management system of each healthcare facility records all prescriptions and drug dispensations, and these data were extrapolated for this retrospective study. Results: A comparative assessment between the first half of 2022 and 2023 (January-June) highlighted a significant increase in beta-lactam antibiotic consumption, showing a twofold rise compared to the previous year's term. Regarding prescription averages, there was a noticeable increase of +29.00% in hospitalizations and +28.00% in hospital discharges within the ASL Napoli 3 South. Conversely, at Policlinico Umberto I, there was a marginal increase of +1.60% in hospitalizations and a decrease of -7.40% in hospital discharges. Conclusions: The study offers valuable insights into expenditure patterns and antibiotic consumption, underscoring the need for enhanced prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings stress the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.
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Affiliation(s)
- Francesco Ferrara
- Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy; (R.P.); (M.C.); (E.N.)
| | - Roberta Pasquinucci
- Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy; (R.P.); (M.C.); (E.N.)
| | - Maurizio Capuozzo
- Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy; (R.P.); (M.C.); (E.N.)
| | - Giacomo Polito
- Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (M.V.); (A.C.)
| | | | - Marcello Vaccaro
- Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (M.V.); (A.C.)
| | - Adriana Coluccia
- Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (M.V.); (A.C.)
| | - Roberto Langella
- Italian Society of Hospital Pharmacy (SIFO), SIFO Secretariat of the Lombardy Region, 20159 Milan, Italy;
| | - Ugo Trama
- Health Protection and Coordination of the Campania Regional Health System, 80143 Naples, Italy;
| | - Eduardo Nava
- Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy; (R.P.); (M.C.); (E.N.)
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