Farmacoriflessioni
Uso di antibiotici in Pediatria
Antibiotici use in paediatrics
S. Di Mario, C. Gagliotti, R. Buttazzi, L. Cisbani, A. Brambilla, M.L. Moro
a nome del Comitato tecnico-scientifico regionale “Progetto ProBA 2014”*
Novembre 2017 - pagg. 578 -583
Abstract
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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Corrispondenza: simona.dimario@regione.emilia-romagna.it