Focus
PEDIATRI & FARMACI
Farmaci essenziali e attitudini prescrittive dei pediatri
ESSENTIAL DRUGS AND PAEDIATRICIANS’ PRESCRIPTIONS
Antonio Clavenna1, Marco Sequi1, Angela Bortolotti2, Ida Fortino2, Luca Merlino2, Maurizio Bonati1
1Laboratorio per la Salute Materno-Infantile, Dipartimento di Salute Pubblica,
Istituto di Ricerche Farmacologiche “Mario Negri”, Milano
2Governo dei Servizi Sanitari Territoriali e Politiche di Appropriatezza e Controllo,
Direzione Generale Sanità, Regione Lombardia, Milano
Novembre 2010 - pagg. 565 -574
Abstract
The objective of the study was to identify which drugs are considered “essential” by Italian
family paediatricians based on their prescriptions. So, prescriptions reimbursed by
the National Health System, involving 923,177 children <14 years old, and dispensed
during 2005 by the retail pharmacies of 15 local health units (LHUs) in Lombardy Region,
were analysed. The percentage of family paediatricians prescribing each single
drug was calculated. In all, 634 different drugs were prescribed to 486,405 children <
14 years old (52.7%). The median number of drugs prescribed by each paediatrician
was 60 (interquartile range 51-71). The number of drugs prescribed by each paediatrician
was correlated with the number of children in charge. A total of 42 drugs from 13
therapeutic classes was prescribed by at least 50% of family paediatricians. Six drugs
were prescribed by all the paediatricians: amoxicillin + clavulanic acid, amoxicillin, beclometasone,
clarithromycin, salbutamol, and cefaclor. In all, 95% of the family paediatricians
prescribed four or more cephalosporins and 92% prescribed four inhaled
steroids. Only 17 of the 42 most frequent drugs are included in the World Health Organization
Essential Medicines for children list. Despite the huge number of drugs prescribed,
only 42 were shared by half of the family paediatricians. Initiatives to evaluate
and promote a more rational use of drugs in Italian children are necessary. A replication
of the study at the international level could identify drugs for which a consensus exists,
with the aim of creating a practice based international formulary.
Classificazione MeSH
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Corrispondenza: clavenna@marionegri.it