Uso degli antibiotici in età pediatrica

The pharmaceutical prescription allows a quantitatively but not qualitative evaluation of a drug as it does not report the reason. The software used by family paediatricians is designed to receive the diagnosis, but the field is not usually filled in. The Pharmaceutical Service of the Piedmont Region has undertaken an experimental study to assess the feasibility of modifying the systems to expand the possibilities of evaluating the use of antibiotic. The work involved 15 paediatricians in the ASL CN1 district and 15 in Verbano-Cusio-Ossola one. In compliance with the available regulations and for about 24 months, the paediatricians voluntarily agreed to include the diagnosis along with an antibiotic prescription. At the end of the observation, more than 70 thousand prescriptions were made, with a slight non-significant increase between 2018 and 2019, in both districts. Prescriptions were compared with the previous year’s data. Information on diagnosis, before the project started, was present in about 40% of prescriptions and increased to 100%. The most diagnosed pathologies were acute bronchitis, acute tonsillitis and otitis media, without differences between CN1 and VCO. The most used antibiotic is amoxicillin in combination with clavulanic acid, which alone accounts for almost half of the prescriptions. At the end of the study, it is possible to affirm that the inclusion of the diagnosis does not seem to have created individual difficulties and/or to have modified the clinical/prescription behaviour. The presence of the data on the diagnosis, however, makes it possible to broaden the system’s ability to read the critical areas present in the prescriptive behaviour and to monitor any trend in relation to its appropriateness and available guidelines. Through a sustainable and minimal intervention, it is possible to expand the capacity of the prescriptive system to evaluate behaviours and to eventually plan targeted actions, consistently with the needs to counteract antibiotic resistance.