Abstract
BackgroundChildren are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections really due to viruses rather than to bacteria. We designed the MAREA study which consisted of two different studies: i) a surveillance study to monitor the safety/efficacy of the antibiotics for the treatment of pneumonia (CAP), pharyngotonsillitis and acute otitis media in children younger than 14 yrs old, living in Liguria, North-West Italy and ii) a pre−/post-interventional study to evaluate the appropriateness of antibiotic prescription for the treatment these infections. In this paper, we show only results of the appropriateness study about the antibiotic prescription for the treatment of pneumonia.MethodsPatients included in this study met the following inclusion criteria: i) admission to the Emergency/Inpatient Dpt/outpatient clinic of primary care pediatricians for pneumonia requiring antibiotics, ii) informed written consent. The practice of prescribing antibiotics was evaluated before-and-after a 1 day-educational intervention on International/National recommendations.ResultsGlobal adherence to guidelines was fulfilled in 45%: main reason for discordance was duration (shorter than recommended). Macrolide monotherapy and cephalosporins were highly prescribed; ampicillin/amoxicillin use was limited. 61% of patients received >1 antibiotic; parenteral route was used in 33%. After intervention, i) in all CAP, cephalosporin prescription decreased (−23%) and the inappropriate macrolide prescriptions was halved and, ii) in not hospitalized CAP (notH-CAP), macrolides were prescribed less frequently (−25%) and global adherence to guidelines improved (+39%); and iii) in H-CAP antibiotic choice appropriateness increase.ConclusionPrescribing practices were sufficiently appropriate but widespread preference for multidrug empirical regimens or macrolide in monotherapy deserve closer investigation.
Highlights
Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections really due to viruses rather than to bacteria
Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections such as pneumonia, we designed the MAREA study: one of the aim of this study was to evaluate the appropriateness of antibiotic prescription for the treatment of pneumonia before and after an educational intervention
Antibiotic prescription before-and-after educational intervention in the whole population of children with pneumonia and in hospitalized (H-CAP) and not-hospitalized pneumonia (NotH-CAP) In all, 225 children enrolled for pneumonia received a total of 400 antibiotic prescriptions
Summary
Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections really due to viruses rather than to bacteria. We designed the MAREA study which consisted of two different studies: i) a surveillance study to monitor the safety/efficacy of the antibiotics for the treatment of pneumonia (CAP), pharyngotonsillitis and acute otitis media in children younger than 14 yrs old, living in Liguria, North-West Italy and ii) a pre−/post-interventional study to evaluate the appropriateness of antibiotic prescription for the treatment these infections. Children are the most vulnerable population exposed to the use of antibiotics often incorrectly prescribed for the treatment of infections such as pneumonia, we designed the MAREA study (farMAcovigilanza in pediatria REgione LiguriA i.e. pharmacolovigilance in pediatric patients in Ligurian Region): one of the aim of this study was to evaluate the appropriateness of antibiotic prescription for the treatment of pneumonia before and after an educational intervention. The findings of this study may further confirm that priority actions for improving the rational use of antibacterials in children should concentrate on education activities such as active participation of the pediatricians to training courses
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