1Servizio Assistenza Territoriale, DG Cura della Persona, Salute e Welfare, 2Agenzia Sanitaria e Sociale Regionale, 3Servizio Strutture, Tecnologie e Sistemi Informativi, DG Cura della Persona, Salute e Welfare,
Regione Emilia-Romagna, Bologna
“Progetto ProBA 2014”*
*Stefano Alboresi, Sergio Amarri, Mara Asciano, Filippo Bernardi, Vincenzo Calabrese, Sergio Capobianco, Tiziano Dall’Osso, Chiara Di Girolamo, Simona Di Mario, Icilio Dodi, Alfredo Ferrari, Sara Forti, Carlo Gagliotti, Giuseppe Gregori, Massimo Magnani, Federico Marchetti, Franco Mazzini, Maria Luisa Moro, Maria Grazia Pascucci, Lamberto Reggiani, Domenico Saggese, Anna Tomesani
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Key words: Antibiotic prescriptions, Surveillance, Children, Emilia-Romagna Region
Inappropriate antibiotic use in paediatric care is a main issue in Italy where prescription rates are among the highest in Europe and wide spectrum antibiotics (e.g. the association amoxicillin + clavulanic acid) are the most prescribed with an increased risk of antibiotic resistance. This paper summarizes the activities and the achievements of the ProBA (Progetto Bambini e Antibiotici), a long-lasting project of the Emilia-Romagna Region (Italy) going on for more than 10 years, which aims at the containment of antibiotic overuse in children. The ProBA is focused on two leading causes of ambulatory visits and antibiotic prescriptions in paediatric primary care (i.e. acute otitis media and sore throat) and consists of the following activities: producing evidence based regional guidelines, developing and disseminating tools for the implementation of the recommendations, monitoring prescription rates and compliance to recommendations, providing regular feedback to family paediatricians and conducting regional information campaign for the general public to promote the correct use of antibiotics. The ProBA is producing a substantial decrease in the antibiotic prescription rates (from 1,277 prescriptions per 1,000 children in 2008 to 881 prescriptions per 1,000 children in 2016) coupled with a relative growth (compared with other antibiotics) of the use of amoxicillin, the first-choice antibiotic for treatment of acute otitis media and streptococcal pharyngitis. Namely, the ratio of amoxicillin versus the association amoxicillin + clavulanic acid has increased from 0.8 in 2008 to 1.1 in 2016. A further evolution of the ProBA is to cross the Emilia-Romagna borders and promote a working-together approach to produce a common set of indicators with the other Italian regions for monitoring antibiotic appropriateness in paediatric care. This could be useful to compare attitude and practice and to define joint objectives of improvement.
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