Antibiotic prescription in italian children: a population-based study in Friuli Venezia Giulia, north-east Italy.

UNLABELLED: Comprehensive information on prescription patterns of antibiotics in Italy is scarce. This study describes the use of systemic antibiotics in children according to age and sex in Friuli Venezia Giulia, north-east Italy. A pharmacological prescription database was used to identify individual prescriptions provided to all 0-15-y-old resident children (n = 140,630) during 1998. Overall, 124,383 prescriptions were identified. The prescription rate was highest in the 3-6 y olds, with 1491 antibiotic prescriptions per 1,000 children per year. Antibiotics were prescribed for 52% of infants, 57.2% of toddlers and 62% of preschool children. Twenty-nine percent of the prescriptions were for cephalosporins, 27% for macrolides and 24% for broad-spectrum penicillins. Prescription rates were much higher than in other countries such as Denmark, with more antibiotic courses prescribed for more children at all ages. Prescriptions from general practitioners and family paediatricians often included second-line antibiotics (e.g. cephalosporins and macrolides) or antibiotics that have not been approved for community-acquired paediatric infections (e.g. quinolones). CONCLUSION: The development of regional guidelines for antibiotic use in children should be urgently recommended.

[Organizational appropriateness of recoveries: results of the evaluation of recoveries by AEP/PRUO at the Careggi Hospital in Florence in 1995-1998]. / Appropriatezza organizzativa dei ricoveri: risultati della valutazione con AEP/PRUO dei ricoveri dell'AO Careggi di Firenze. Anni 1995 e 1998.

The organizational appropriateness of hospital stays is an expression of a hospital's efficiency and aim of the management control. The AEP (American Version)/PRUO (Italian Version) protocol is specific for measuring the organizational appropriateness of hospital stays. The aim of this study is the comparative analysis of the organizational appropriateness of hospital stays in Careggi Hospital of Florence and in all hospital Departments in 1995 and 1998. In 1998 the AEP/PRUO protocol was applied to 2148 samples of hospital stays out of 38,968 eligible hospitalizations, and in 1995 a sample of 1989 hospital stays out of 35,108. In 1998 2,148 admissions and 15,338 days of hospitalization were tested. In 1995, 1989 admission days and 12,264 days of hospitalization were tested, 63 departments were studied. In 1995 the first edition of the protocol was applied, in 1998 the second. A sample of 218 of the 1998 hospital stays was tested with both editions to evaluate the impact of differences. In 1998, with the second edition of the protocol, the inappropriateness rate of admission days and hospitalization days and the rate of in-patients inappropriate hospital stays was respectively 38.0%, 43.8% and 18.5%. Compared with 1995 results, the rates increased +6.2%, 6% and +7.5% respectively. Instead, with the first edition of the protocol, the rates were 29.7%, 37.6% and 10.7% and, compared with 1995, they were reduced -2.1%, -0.6% and -0.3%. The longitudinal multilevel analysis has allowed the evaluation of the performance of each department.

[Variation in drug prescription costs and general practitioners in an area of North-East Italy. The use of current data]. / Variabilità della spesa per le prescrizioni farmaceutiche in medicina generale in un'area del friuli Venezia giulia. L'uso dei dati correnti.

In this paper we analyse all General Practitioners (GP) prescriptions in a Friuli-Venezia Giulia area (North-eastern Italy). The sample included of 181 GPs and 242,564 patients with 1,191,122 prescribed items. The regional Health Data Base is the source of all data. Data analysis was performed according to the multiple regression and LISREL models. We assessed for all GPs the years of medical profession, patients listed, percent of patients exent from prescription rates, patients over 60, number of active compounds prescribed and related drug companies. Two factors, the number of active compounds prescribed and patients listed, significantly contributed to the multiple regression model. The model explained 56% of variation in prescribing pointing out the importance of those factors in influencing the cost per patient. LISREL model shows a causal chain going from the years of medical profession to cost per patient passing through the number of active compounds and drug companies related. In fact, the older the GP the less the cost per patient and number of active compounds used. A main finding is that the cost per patient is highly influenced by the number of different active compounds prescribed. As in other studies the percent of patients exent from prescriptions rates and aged over 60 are somehow fundamental in influencing the cost per patient. Finally we discussed models and literature on the issue.