J Pediatr Infect Dis 2014; 09(01): 001-009
DOI: 10.3233/JPI-140405
Review Article
Georg Thieme Verlag KG Stuttgart – New York

Use of amoxicillin, amoxicillin/clavulanate and cefaclor in the Italian pediatric population

Giangiacomo Nicolini
Pediatrics Unit, San Martino Hospital, Belluno, Italy
,
Daniele Donà
Department of Pediatrics, University of Padova, Padova, Italy
,
Teresa Mion
Department of Pediatrics, University of Padova, Padova, Italy
,
Alessia Barlotta
Department of Pediatrics, University of Padova, Padova, Italy
,
Silvia Girotto
PEDIANET Project, Padova, Italy
,
Eleonora Borgia
Department of Pediatrics, University of Padova, Padova, Italy
,
Genny Franceschetto
PEDIANET Project, Padova, Italy
,
Antonio Scamarcia
PEDIANET Project, Padova, Italy
,
Gino Picelli
PEDIANET Project, Padova, Italy
,
Luigi Cantarutti
PEDIANET Project, Padova, Italy
,
Carlo Giaquintob
Department of Pediatrics, University of Padova, Padova, Italy
,
on behalf of Pedianet› Author Affiliations

Subject Editor:
Further Information

Publication History

13 March 2013

14 September 2013

Publication Date:
28 July 2015 (online)

Abstract

Antibiotics are the most prescribed drugs in children, often administered without any specific diagnosis. In Italy, Family Pediatricians prescribe antibiotics more frequently than in other Europe countries, the commonest being amoxicillin, amoxicillin/clavulanate and cefaclor. We conducted a retrospective cohort study of children up to 12 years old, included in the database Pedianet, who received at least one prescription of amoxicillin, amoxicillin/clavulanate or cefaclor during the period 1st January 2003 to 30th June 2007. 335,352 antibiotics prescriptions in 110,747 children were included in the study. There were 168,458 prescriptions of amoxicillin, amoxicillin/clavulanate or cefaclor, amounting to 50.2% of antibiotic prescriptions. The main indication was unspecified-upper respiratory tract infection (26.5%). Overall, amoxicillin/clavulanate was the most commonly prescribed antibiotic in older children, while amoxicillin was the most prescribed in younger patients. Amoxicillin was the most prescribed antibiotic in all age groups (p < 0.0001) for upper respiratory tract infections, otitis media and acute bronchitis. A therapeutic switch occurred in 0.6% of cases, and was most frequent in pneumonia. This was a retrospective study carried out using software designed for the routine practice and not for specific studies; therefore several limitations on the data interpretation need to be considered especially on the diagnosis. However, the study shows that antibiotic consumption in the Italian pediatric population exceeds the European average, with three beta-lactam drugs accounting for over half of all antibiotic prescriptions.