Abstract | OBJECTIVE: To evaluate the quality of paediatricians' antibiotic prescribing using administrative databases. METHODS: The data source was the database of reimbursed prescriptions of the Lombardy Region, Italy. Children 1-13 years were included. An index prescription was defined as the first antibiotic prescription during a year period (2011) that occurred without previous, recent, antibiotic prescriptions or hospital or emergency department admissions. The A indicator was the percentage of children, cared for by paediatricians, receiving amoxicillin at the index prescription (minimum target 50%). The B indicator was the percentage of children receiving exclusively non- penicillin antibiotics in unrelated infection episodes (maximum target 10%). Indicators were evaluated for each prescriber and geographical area. RESULTS: Overall 424 280 children (cared for by 1164 paediatricians) received an index prescription and were included in the study. Amoxicillin alone was prescribed at the index prescription only to 23.6% of children (7.9%-46.3% within different areas of the region).The percentage of paediatricians who reached the target for the quality indicators was low (12.8% A indicator; 54.0% B indicator; 11.3% both). Almost half of the paediatricians (44.5%) showed inadequate quality of antibiotic prescribing, failing to reach the target for both indicators. Quality of prescribing was about four times worse in high prescribers and younger paediatricians. A geographical cluster of paediatricians reaching the target for both indicators was identified. These paediatricians had, for several years, previously been involved in educational programme. CONCLUSIONS: Quality of prescribing was generally unsatisfactory, but increased in a group of paediatricians previously involved in educational interventions and increased with increasing age. Further studies are warranted in order to validate these promising indicators as a benchmarking tool in other studies, when diagnosis is unknown.
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Authors | Daniele Piovani, Antonio Clavenna, Massimo Cartabia, Angela Bortolotti, Ida Fortino, Luca Merlino, Maurizio Bonati |
Journal | BMJ paediatrics open
(BMJ Paediatr Open)
Vol. 1
Issue 1
Pg. e000169
( 2017)
ISSN: 2399-9772 [Electronic] England |
PMID | 29637165
(Publication Type: Journal Article)
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