ArticleBMJ paediatrics open2017
Assessing the quality of paediatric antibiotic prescribing by community paediatricians: a database analysis of prescribing in Lombardy.
Article in BMJ paediatrics open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Factors associated with inappropriateness of antibiotic prescriptions for acutely ill children presenting to ambulatory care in high-income countries: a systematic review and meta-analysis.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Appropriateness of antibiotic prescribing in paediatrics: retrospective controlled study assessing a multifaceted intervention in Northern Italy in a 7-year period.BMJ paediatrics open · 2024Article
- Prescribing Antibiotics for Children with Acute Conditions in Public Primary Care Clinics in Singapore: A Retrospective Cohort Database Study.Antibiotics (Basel, Switzerland) · 2024Article
- Outpatient Antibiotic Prescribing Patterns in Children among Primary Healthcare Institutions in China: A Nationwide Retrospective Study, 2017-2019.Antibiotics (Basel, Switzerland) · 2024Article
- Antibiotic Prescribing Patterns in Paediatric Primary Care in Italy: Findings from 2012-2018.Antibiotics (Basel, Switzerland) · 2021Article
- Physicians' clinical experience and its association with healthcare quality: a systematised review.BMJ open quality · 2021Article
- Evaluation of rational prescribing in paediatrics.BMJ paediatrics open · 2021Article
- Proxy indicators to estimate the appropriateness of medications prescribed by paediatricians in infectious diseases: a cross-sectional observational study based on reimbursement data.JAC-antimicrobial resistance · 2020Article
- Best practices, challenges and innovations in pediatrics in 2019.Italian journal of pediatrics · 2020Review
- Antibiotic prescriptions in acute otitis media and pharyngitis in Italian pediatric outpatients.Italian journal of pediatrics · 2019Observational
- Antibiotic prescription in the outpatient paediatric population attending emergency departments in Lombardy, Italy: a retrospective database review.BMJ paediatrics open · 2019Article
- Multidisciplinary Initiative to Increase Guideline-concordant Antibiotic Prescription at Discharge for Hospitalized Children with Uncomplicated Community-acquired Pneumonia.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the quality of paediatricians' antibiotic prescribing using administrative databases.
methodsThe data source was the database of reimbursed prescriptions of the Lombardy Region, Italy. Children 1-13 years were included. An index prescription was defined as the first antibiotic prescription during a year period (2011) that occurred without previous, recent, antibiotic prescriptions or hospital or emergency department admissions. The A indicator was the percentage of children, cared for by paediatricians, receiving amoxicillin at the index prescription (minimum target 50%). The B indicator was the percentage of children receiving exclusively non-penicillin antibiotics in unrelated infection episodes (maximum target 10%). Indicators were evaluated for each prescriber and geographical area.
resultsOverall 424 280 children (cared for by 1164 paediatricians) received an index prescription and were included in the study. Amoxicillin alone was prescribed at the index prescription only to 23.6% of children (7.9%-46.3% within different areas of the region).The percentage of paediatricians who reached the target for the quality indicators was low (12.8% A indicator; 54.0% B indicator; 11.3% both). Almost half of the paediatricians (44.5%) showed inadequate quality of antibiotic prescribing, failing to reach the target for both indicators. Quality of prescribing was about four times worse in high prescribers and younger paediatricians. A geographical cluster of paediatricians reaching the target for both indicators was identified. These paediatricians had, for several years, previously been involved in educational programme.
conclusionsQuality of prescribing was generally unsatisfactory, but increased in a group of paediatricians previously involved in educational interventions and increased with increasing age. Further studies are warranted in order to validate these promising indicators as a benchmarking tool in other studies, when diagnosis is unknown.
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