Prescription of antibiotics in PAediatrics in the Piedmont Region (ITALY) between 2012-2018

Key words: Antibiotic prescriptions, Epidemiologic surveillance, Paediatrics

Background - he variability in the prescription of antibiotics in the infant population registers changes that cannot always be explained by the associated morbidity alone. Italy, despite its decreasing trend, is still among those countries with the highest prescriptions and shows an important inter-regional variability. The Pharmaceutical Service of the Piedmont Region gave the start to a working group with the task of describing the prescriptive activities, evaluating any internal variability and proposing strategies for improvement.
Aim - The aim of the work is to describe the results achieved in Piedmont in 2012-2018 with regard to the paediatric treatment.
Materials and methods - Data on prescriptions in paediatrics, grouped for ATC, were obtained from the regional pharmaceutical prescription system. Prescriptive rates and treatment prevalence - children with at least one prescription during the year - were calculated for the total number of residents.
Results - The overall rate was reduced from 931 to 689 prescriptions per thousand children. In the same period, the prevalence of prescriptions was also reduced from 45.5% to 34.8%. Non-associated amoxicillin accounted for less than 15% of prescriptions, while clavulanate amoxicillin was the most widely used antibiotic with the 45% of the prescriptions. The ratio of amoxicillin to clavulanate amoxicillin remained strongly negative over the entire period, although it slightly improved from 0.27 to 0.42.
Conclusion - The proportion of treatments, though decreasing, is still far from those of other virtuous European nations. Amoxicillin, unlike what suggested by inter-national and national guidelines, is the least prescribed antibiotics with an excess in clavulanate amoxicillin prescriptions that is difficult to explain. According to recent AIFA reports, the observed differences seem to depend partly on the patient's family but mainly on the prescriptive behaviours. Therefore, the professionals involved should compare prescribing practices to further improve prescriptive appropriateness.