Affiliations: Pediatrics Unit, San Martino Hospital, Belluno,
Italy | Department of Pediatrics, University of Padova,
Padova, Italy | PEDIANET Project, Padova, Italy
Abstract: Antibiotics are the most prescribed drugs in children, often
administered without any specific diagnosis. In Italy, Family Pediatricians
prescribe antibiotics more frequently than in other Europe countries, the
commonest being amoxicillin, amoxicillin/clavulanate and cefaclor. We conducted
a retrospective cohort study of children up to 12 years old, included in the
database Pedianet, who received at least one prescription of amoxicillin,
amoxicillin/clavulanate or cefaclor during the period 1st January 2003 to 30th
June 2007. 335,352 antibiotics prescriptions in 110,747 children were included
in the study. There were 168,458 prescriptions of amoxicillin,
amoxicillin/clavulanate or cefaclor, amounting to 50.2% of antibiotic
prescriptions. The main indication was unspecified-upper respiratory tract
infection (26.5%). Overall, amoxicillin/clavulanate was the most commonly
prescribed antibiotic in older children, while amoxicillin was the most
prescribed in younger patients. Amoxicillin was the most prescribed antibiotic
in all age groups (p < 0.0001) for upper respiratory tract infections,
otitis media and acute bronchitis. A therapeutic switch occurred in 0.6% of
cases, and was most frequent in pneumonia. This was a retrospective study
carried out using software designed for the routine practice and not for
specific studies; therefore several limitations on the data interpretation need
to be considered especially on the diagnosis. However, the study shows that
antibiotic consumption in the Italian pediatric population exceeds the European
average, with three beta-lactam drugs accounting for over half of all
antibiotic prescriptions.
Keywords: Pediatric antibiotics, amoxicillin/clavulanate, amoxicillin, cefaclor, antibiotics, children
