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The European Journal of Public Health Advance Access published online on April 5, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp040
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Antibiotic prescribing in paediatric populations: a comparison between Viareggio, Italy and Funen, Denmark

Gaia Lusini1, Francesco Lapi2,3, Benocci Sara3, Alfredo Vannacci2, Alessandro Mugelli2, Jakob Kragstrup4 and Lars Bjerrum4

1 Hospital Pharmacy, ASL 9 Hospital, Via Senese no 151, 58100 Grosseto, Italy
2 Tuscan Regional Centre of Pharmacovigilance, Department of Pharmacology, University of Florence, Viale G. Pieraccini no 6, 50139 Florence, Italy
3 Regional Health Agency of Tuscany, Epidemiology Unit, Viale G. Pieraccini no 6, 50129 Florence, Italy
4 Research Unit for General Practice, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C, Denmark

Correspondence: Francesco Lapi, Tuscan Regional Centre of Pharmacovigilance, Regional Health Agency of Tuscany, Epidemiology Unit and Department of Pharmacology, University of Florence Viale G. Pieraccini no 6, 50139, Florence, Italy, tel: +39 0554 271 255, fax: +39 0554 271 255, e-mail: francesco.lapi{at}unifi.it

Received May 7, 2008 , accepted February 27, 2009

Background: High rates of antibiotic prescribing in paediatric populations represent a major issue because of the problem of antibiotic resistance. North European countries reported an appropriate use of antibiotics in general population; few studies on this issue have been conducted until now, especially in Italy. Therefore a comparison concerning paediatric antibiotic prescribing rates between an Italian administrative area in Tuscany (Viareggio) and the county of Funen (Denmark) was conducted. Methods: Reimbursement data from 2003 were gathered from the Tuscany Health Authority database and from the database containing pharmacy dispensing data from the Danish Medicines Agency. All data were converted to Defined Daily Doses (DDD) per 1000 inhabitants per day (DDD/TID). Data were broken down by age, identifying four age groups: 0–4, 5–9, 10–14, 15–19 years. Results: The overall prescription of antibiotics to paediatric patients from 0 to 19 years of age was higher in Viareggio (67 DDD/TID) than in Funen (35 DDD/TID). In Viareggio amoxicillin and amoxicillin plus enzyme inhibitors ranked in the first two places as the most frequently prescribed antibiotics in the whole population. Cephalosporins were also heavily used in Viareggio with cefaclor being the third most frequently prescribed antibiotic, especially in the 0–4 and 5- to 9-year-old age groups. In Funen, phenoxymethylpenicillin was the most commonly used antibiotic in all age groups, representing almost one-third of prescriptions, followed by amoxicillin. Conclusions: The paediatric antibiotic prescription rate is substantially higher in Viareggio compared with Funen. These data confirm possible overuse and misuse of antibiotics in the Italian paediatric population.

Keywords: antibiotic prescription, drug utilization, paediatric population.


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