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24. Filippi A, Vannuzzo D, Bignamini AA, Mazzaglia G, Brignoli O, Sabatini A, Cricelli C, Cata-
pano AL. Secondary prevention of myocardial infarction: a survey in primary care.
J Cardiovasc Med (Hagerstown). 2006;7:422-426.
ABSTRACT. OBJECTIVE: To collect information on the major risk factors and secondary pre-
vention among patients with myocardial infarction in Italy. METHODS: Data were obtained
from the database of the Italian College of General Practitioners; 3588 patients (mean age
68.7 +/- 11.3 years; 2698 men, 888 women; two unrecorded gender), with an average
time from event of 6 +/- 5.7 years, were identified. RESULTS: Among the major risk factors,
data entry ranged from 50.3% for physical activity to 74.9% for blood pressure. Inadequa-
te blood pressure control was present in 49.2% and elevated plasma cholesterol levels (>
5.2 mmol/l) in 57.3%; among the latter group, 65% were on lipid-lowering therapy. Only
47.2% of the treated patients achieved a total cholesterol level of < 5.2 mmol/l. Antiplatelet
or anticoagulant drugs, beta-blockers, and angiotensin-converting enzyme inhibitors were
prescribed to 43%, 10.3%, and 57.9% of patients, respectively. CONCLUSIONS: The pre-
ventive attitude of Italian general practitioners is similar to that reported in other European
countries with two noticeable exceptions: under-prescription of beta-blockers and of anti-
platelet drugs. Clearly, secondary prevention requires major improvement.
25. Galatti L, Sessa A, Mazzaglia G, Pecchioli S, Rossi A, Cricelli C, Schito GC, Nicoletti G.
Antibiotic prescribing for acute and recurrent cystitis in primary care: a 4 year
descriptive study.
J Antimicrob Chemother. 2006; 57:551-6.
ABSTRACT. OBJECTIVES: To explore the antibiotic prescribing pattern for cystitis and the
patient-related variables associated with prescription during a 4 year period among Italian
general practitioners (GPs). METHODS: We obtained information from the `Health Search Da-
tabasČ (HSD), an Italian general practice research database. From a total sample of 457 672
eligible patients aged >16 years registered up to December 2002, we included those whose
diagnoses could be classified as acute (uncomplicated and complicated) and recurrent cystitis.
Patients' features and prevalence of antibiotic users were assessed. RESULTS: Of 35 129 cases
diagnosed during the period 1999-2002, 96.0% of them were acute cystitis (39.2% recorded
as uncomplicated). The prevalence of cases with acute complicated and uncomplicated cystitis
slightly increased during the 4 year period, whereas it remained stable for recurrent cysti-
tis. Most of the cystitis cases reported no diagnostic tests. More than 70% of patients were
prescribed with at least one antibiotic, with a 4-fold increased risk of antibiotic use for acute
cystitis throughout the study period. The prevalence of antibiotic users reached 86.2% for
both acute uncomplicated and complicated cystitis in 2002, and 81.5% for recurrent cystitis.
Fluoroquinolones represented the most common antibiotics being prescribed although they
markedly decreased during these years. Fosfomycin trometamol use increased dramatically,
becoming the first choice for any type of cystitis. CONCLUSIONS: Data indicate an evident rise
in antibiotic use mostly related to fosfomycin trometamol. They also indicate that such a pre-
scriptive trend finds confirmation from the available evidence for acute uncomplicated cystitis,
although the management of recurrent cystitis could be further improved.
26. Mazzaglia G, Mantovani LG, Sturkenboom MC, Filippi A, Trifiro G, Cricelli C, Brignoli O,
Caputi AP. Patterns of persistence with antihypertensive medications in newly
diagnosed hypertensive patients in Italy: a retrospective cohort study in primary
. J Hypertens. 2005;23:2093-100.
ABSTRACT. OBJECTIVE: To describe patterns of persistence and related primary care costs
associated with first antihypertensive treatment. DESIGN AND SETTING: Retrospective co-
hort study during 2000-2001, using information from 320 Italian general practitioners.
PARTICIPANTS: We studied 13 303 patients with newly diagnosed hypertension, who
received a first single antihypertensive prescription within 3 months after diagnosis. MAIN