ESSENTIAL DRUGS AND PAEDIATRICIANS’ PRESCRIPTIONS

Key words: Essential drugs, Family paediatricians, Rational use

The objective of the study was to identify which drugs are considered “essential” by Italian family paediatricians based on their prescriptions. So, prescriptions reimbursed by the National Health System, involving 923,177 children <14 years old, and dispensed during 2005 by the retail pharmacies of 15 local health units (LHUs) in Lombardy Region, were analysed. The percentage of family paediatricians prescribing each single drug was calculated. In all, 634 different drugs were prescribed to 486,405 children < 14 years old (52.7%). The median number of drugs prescribed by each paediatrician was 60 (interquartile range 51-71). The number of drugs prescribed by each paediatrician was correlated with the number of children in charge. A total of 42 drugs from 13 therapeutic classes was prescribed by at least 50% of family paediatricians. Six drugs were prescribed by all the paediatricians: amoxicillin + clavulanic acid, amoxicillin, beclometasone, clarithromycin, salbutamol, and cefaclor. In all, 95% of the family paediatricians prescribed four or more cephalosporins and 92% prescribed four inhaled steroids. Only 17 of the 42 most frequent drugs are included in the World Health Organization Essential Medicines for children list. Despite the huge number of drugs prescribed, only 42 were shared by half of the family paediatricians. Initiatives to evaluate and promote a more rational use of drugs in Italian children are necessary. A replication of the study at the international level could identify drugs for which a consensus exists, with the aim of creating a practice based international formulary.