Betalactams

Antibiotics are the most prescribed drugs in pediatric age, often administered without any specific diagnosis. In Italy, Family Pediatricians (FP) prescribe antibiotics more frequently than in other Europe countries. In particular, amoxicillin, amoxicillin/clavulanate and cefaclor are the most used in our Country. We wanted to assess the pattern of use of these beta-lactams in an Italian pediatric population, considered by age and sex, with particular regard to indications, dosage regimens, duration of treatment and therapeutic switch. It was conducted a retrospective cohort study collecting data from Pedianet enlisted children up to 12 years old who have received at least one prescription of amoxicillin, amoxicillin/clavulanate or cefaclor during the period from 1st January 2003 to 30th June 2007. 

It was found out a total of 335.352 antibiotics prescriptions in 110.747 children included in the study. Amoxicillin, amoxicillin/clavulanate and cefaclor, with the amount of 155.473 administrations, covered 46.4% of antibiotics prescriptions. The main diagnosis was viral-upper respiratory tract infection (25.1%). Amoxicillin was the most prescribed antibiotic in all age groups (p<0.0001) in children with upper respiratory tract infections, otitis and bronchitis; regardless of the diagnosis, amoxicillin-clavulanate was prescribed more frequently in older children, while amoxicillin was the most prescribed in younger patients. A therapeutic switch occurs in 0.6%, appearing to be more frequent for pneumonia. 

In conclusion it was possible to claim that antibiotics consumption in the Italian pediatric population exceeds the European average. Three beta-lactams represent almost half of antibiotics prescriptions, namely amoxicillin, amoxicillin-clavulanate and cefaclor, in decreasing order. Cefaclor is used also in diseases in which it’s not recommended or it’s however not recommended as a first-choice antibiotic.