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Observational pre-post study showed that a quality improvement project reduced paediatric antibiotic prescribing

Simona Di Mario1, Carlo Gagliotti2, Rossella Buttazzi2

  • 1Primary Care Service, Regional Health Authority of Emilia-Romagna, Bologna, Italy.

Acta Paediatrica (Oslo, Norway : 1992)
|May 4, 2018
PubMed

Insights

A quality improvement project significantly reduced antibiotic prescriptions in Italian paediatric primary care. This initiative promoted more considered antibiotic use among children, showing positive prescribing trends.

Area of Science:

  • Public Health
  • Pediatric Medicine
  • Infectious Disease Management

Background:

  • Antibiotic overuse in paediatric primary care is a significant public health concern.
  • Promoting judicious antibiotic prescribing is crucial for combating antimicrobial resistance.
  • Previous interventions have shown variable success in modifying prescribing habits.

Purpose of the Study:

  • To evaluate the effectiveness of a comprehensive quality improvement project on antibiotic prescribing in paediatric primary care.
  • To assess changes in overall antibiotic prescription rates and the use of specific antibiotic classes in children.
  • To compare prescribing trends in a region with interventions versus the rest of the country.

Main Methods:

  • Observational pre-post study design using patient-level prescribing data (2005-2016).
  • Implementation of multilevel interventions including guidelines, audits, public campaigns, and incentives.
  • Monitoring of total antibiotic prescriptions for children (0-13 years) and specific drug ratios.

Main Results:

  • Significant reduction in antibiotic prescribing rates from 1307 to 881 per 1000 children (p<0.001).
  • Increased ratio of amoxicillin to amoxicillin-clavulanic acid (0.6 to 1.1, p=0.001).
  • Declines in second-choice antibiotic prescriptions; stable high rates in non-intervention areas.

Conclusions:

  • The quality improvement project effectively promoted more considered antibiotic prescribing in paediatric primary care.
  • The findings suggest a successful model for regional antibiotic stewardship initiatives.
  • Further research is warranted to validate these results in diverse healthcare settings.
Abstract

Keywords:
Antibiotic prescriptionsItalyPaediatric primary careQuality improvementSurveillance

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