Observational studyItalian journal of pediatrics2019
Antibiotic prescriptions in acute otitis media and pharyngitis in Italian pediatric outpatients.
Observational study in Italian journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Treatment of acute pharyngitis in children: an Italian intersociety consensus (SIPPS-SIP-SITIP-FIMP-SIAIP-SIMRI-FIMMG).Italian journal of pediatrics · 2024Guideline
- Antibiotic treatment to prevent pediatric acute otitis media infectious complications: A meta-analysis.PloS one · 2024Pooled it
- Homeopathic Medicines for the Treatment of Acute Otitis Media: a Real-World Cohort Study on Recurrences and Antibiotic Prescriptions Compared to those with Conventional Treatments.Homeopathy : the journal of the Faculty of Homeopathy · 2026Article
- The Impact of Point-of-Care Testing for Group A Streptococcal Pharyngitis on Antibiotic Prescribing and Patient Health Outcomes in Outpatient Care: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Open forum infectious diseases · 2025Article
- Mechanism of Action and Efficacy of Wu-Hua-Yan-Xiao in the Treatment of Pediatric Acute Pharyngitis Based on Network Pharmacology and Experimental Validation.Drug design, development and therapy · 2025Article
- Impact of a multifaceted antibiotic stewardship programme in a paediatric acute care unit over 8 years.JAC-antimicrobial resistance · 2024Article
- 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
- Group A Streptococcus infections in children and adolescents in the post-COVID-19 era: a regional Italian survey.Italian journal of pediatrics · 2024Article
- Article
- Monitoring the Epidemiology of Otitis Using Free-Text Pediatric Medical Notes: A Deep Learning Approach.Journal of personalized medicine · 2023Article
- Leveraging machine learning to distinguish between bacterial and viral induced pharyngitis using hematological markers: a retrospective cohort study.Scientific reports · 2023Article
- Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives.European journal of pediatrics · 2023Review
- Article
- Article
- The Economic Burden of Pneumococcal Disease in Children: A Population-Based Investigation in the Veneto Region of Italy.Children (Basel, Switzerland) · 2022Article
- Antibiotic Prescription Patterns in the Paediatric Primary Care Setting before and after the COVID-19 Pandemic in Italy: An Analysis Using the AWaRe Metrics.Antibiotics (Basel, Switzerland) · 2022Article
- Non-bullous Impetigo: Incidence, Prevalence, and Treatment in the Pediatric Primary Care Setting in Italy.Frontiers in pediatrics · 2022Article
- Antibiotic Prescribing Patterns in Paediatric Primary Care in Italy: Findings from 2012-2018.Antibiotics (Basel, Switzerland) · 2021Article
- Causality and avoidability of adverse drug reactions of antibiotics in hospitalized children: a cohort study.International journal of clinical pharmacy · 2021Article
- Use of the Bacterial Lysate OM-85 in the Paediatric Population in Italy: A Retrospective Cohort Study.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute otitis media (AOM) and pharyngitis are very common infections in children and adolescents. Italy is one of the European countries with the highest rate of antibiotic prescriptions. The aim of this study is to describe first-line treatment approaches for AOM and pharyngitis in primary care settings in Italy over six years, including the prevalence of 'wait and see' for AOM, where prescription of antibiotics is delayed 48 h from presentation, and differences in prescribing for pharyngitis when diagnostic tests are used.
methodsThe study is a secondary data analysis using Pedianet, a database including data at outpatient level from children aged 0-14 in Italy. Prescriptions per antibiotic group, per age group and per calendar year were described as percentages. "Wait and see" approach rate was described for AOM and pharyngitis prescriptions were further grouped according to the diagnostic test performed and test results.
resultsWe identified 120,338 children followed by 125 family pediatricians between January 2010 and December 2015 for a total of 923,780 person-years of follow-up. Among them 30,394 (mean age 44 months) had at least one AOM diagnosis (n = 54,943) and 52,341 (mean age 5 years) had at least one pharyngitis diagnosis (n = 126,098). 82.5% of AOM diagnoses were treated with an antibiotic within 48 h (mainly amoxicillin and amoxicillin/clavulanate) and the "wait and see" approach was adopted only in 17.5% of cases. The trend over time shows an increase in broad spectrum antibiotic prescriptions in the last year (2015). 79,620 (63%) cases of pharyngitis were treated and among GABHS pharyngitis confirmed by rapid test 56% were treated with amoxicillin. The ones not test confirmed were treated mainly with broad spectrum antibiotics.
conclusionsDespite guidance to use the 'wait and see' approach in the age group analyzed, this strategy is not often used for AOM, as previously noted in other studies in hospital settings. Broad-spectrum antibiotic prescription was more frequent when pharyngitis was not confirmed by rapid test, in keeping with evidence from other studies that diagnostic uncertainty leads to overuse of antibiotics.
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