Observational pre–post study showed that a quality improvement project reduced paediatric antibiotic prescribing rates in primary care. (25th May 2018)

• Record Type: Journal Article
• Authors: Di Mario, Simona; Gagliotti, Carlo; Buttazzi, Rossella; Cisbani, Luca; Di Girolamo, Chiara; Brambilla, Antonio; Moro, Maria Luisa
• Other Names: Alboresi Stefano investigator.; Amarri Sergio investigator.; Asciano Mara investigator.; Bernardi Filippo investigator.; Calabrese Vincenzo investigator.; Capobianco Sergio investigator.; Dall'Osso Tiziano investigator.; Dodi Icilio investigator.; Ferrari Alfredo investigator.; Forti Sara investigator.; Gregori Giuseppe investigator.; Magnani Massimo investigator.; Marchetti Federico investigator.; Mazzini Franco investigator.; Pascucci Maria Grazia investigator.; Reggiani Lamberto investigator.; Saggese Domenico investigator.; Tomesani Anna investigator.
• Is Part Of: Acta pædiatrica. Volume 107:Number 10(2018)
• Page Start: 1805
• Page End: 1809
• Publication Date: 2018-05-25
• Subjects: Antibiotic prescriptions -- Italy -- Paediatric primary care -- Quality improvement -- Surveillance; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.14381
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: Aim: This study assessed the effectiveness of a quality improvement project that aimed to promote more considered antibiotic prescribing in paediatric primary care. Method: This was an observational pre–post study that used patient‐level prescribing data from the Emilia‐Romagna region of Italy to monitor indicators from 2005 to 2016. Multilevel interventions and activities were started in 2007 and these included developing guidelines and updates, disseminating evidence, audits and feedback, public information campaigns, engaging health managers and performance incentives. The primary outcomes were total antibiotic prescription rates for children aged 0–13 years and the rates for specific drugs. Results: The intervention was associated with a significant reduction in the antibiotic prescribing rate, from 1307 per 1000 children in 2005 to 881 prescriptions in 2016 (p for trend <0.001), and a significant increase in the ratio of amoxicillin to amoxicillin–clavulanic acid, from 0.6 to 1.1 (p for trend = 0.001). Prescriptions of other second‐choice antibiotics also declined significantly. In contrast, antibiotic prescribing rates remained high in the rest of Italy. Conclusion: The intervention was effective in promoting a more considered use of antibiotic in paediatric primary care in an Italian region. Further studies are needed to confirm its effectiveness in other settings.