Drug prescriptions to outpatient children: a review of the literature

Clavenna, Antonio; Bonati, Maurizio

doi:10.1007/s00228-009-0679-7

Cited by 105 publications

(104 citation statements)

References 31 publications

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“…The results regarding the profile of drug use in the four weeks prior to hospitalization were consistent with findings from national and international drug utilization studies [24,25].…”

Section: Discussionsupporting

confidence: 83%

Active surveillance of adverse drug reactions in children in five Italian paediatric wards

Gallo¹,

Clavenna²,

Bonati³

et al. 2012

OJPed

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Adverse drug reactions (ADRs) are an important clinical problem and contribute significantly to mortality and morbidity. Scant data on the safety of drug use in children are usually available at the time of marketing authorization, due to the limited number of trials performed in the paediatric population. Few studies monitored the incidence of ADRs in Italian hospitalized children, that cannot be compared for methodological reasons. A 6-month prospective observational study was, therefore, conducted on the paediatric wards of five hospitals in the Campania Region, Italy. Data were collected on all patients admitted to the wards during the study period through a structured questionnaire administered to the mothers and through a hospital chart review. Of the 752 patients enrolled, 86.2% were exposed to one or more drugs during hospitalization. The therapeutic class most prescribed was systemic antibacterial agents (47%). Six ADRs occurred during hospitalization (incidence 0.9%; 95% CI 0.2% -1.7%). In addition, one child was admitted to a hospital for an ADR. Five out of seven ADRs occurred in girls. The skin was the most affected organ. The medications implicated were amoxicillin, acyclovir, ibuprofen, ceftriaxone, paracetamol, and ranitidine. According to the Naranjo probability criteria, six ADRs were probably, and one possibly, related to the suspected drug. In conclusion, this study reveals that ADRs may be under-reported in children hospitalized in the Campania Region. Consequently, healthcare personnel should be alert to the possibility of ADRs. More accurate reporting of ADRs in children would result in safer use of drugs in such patients.

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“…The results regarding the profile of drug use in the four weeks prior to hospitalization were consistent with findings from national and international drug utilization studies [24,25].…”

Section: Discussionsupporting

confidence: 83%

Active surveillance of adverse drug reactions in children in five Italian paediatric wards

Gallo¹,

Clavenna²,

Bonati³

et al. 2012

OJPed

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“…A limit, as underlined in a recent review on drug utilization studies [31], is the wide variety of studies, with differences in study type (design and method), populations (in terms of sample size and age groups), and data collected, making comparative evaluation difficult or at best incomplete. Another limit is that data were available for comparison between only six countries, most of which were European.…”

Section: Discussionmentioning

confidence: 99%

“…If for Canada the high ranking can be justified by a high prevalence of asthma, the same is not true for Italy, where the prescribing pattern for antibiotics shows a similar profile [31,33]. This suggests that the differences in drug prescription rates may be attributable to different prescribing attitudes and national drug regulatory policies more than differences in the prevalence of asthma.…”

Section: Inter-country Quantitative Differencesmentioning

confidence: 99%

Inter-country variations in anti-asthmatic drug prescriptions for children. Systematic review of studies published during the 2000–2009 period

Bianchi

Clavenna

Bonati

2010

Eur J Clin Pharmacol

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“…Antibiotiki so med najpogostejšimi zdravili, ki jih predpisujemo otrokom, največkrat v predšolskem obdobju (1,2).…”

Section: Uvodunclassified

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

et al. 2017

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Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015.Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region.Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists.Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

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Drug prescriptions to outpatient children: a review of the literature

Cited by 105 publications

References 31 publications

Active surveillance of adverse drug reactions in children in five Italian paediatric wards

Active surveillance of adverse drug reactions in children in five Italian paediatric wards

Inter-country variations in anti-asthmatic drug prescriptions for children. Systematic review of studies published during the 2000–2009 period

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

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