Antibiotic Prescription Patterns in the Paediatric Primary Care Setting before and after the COVID-19 Pandemic in Italy: An Analysis Using the AWaRe Metrics
Elisa Barbieri,
Cecilia Liberati,
Anna Cantarutti,
Costanza Di Chiara,
Angela Lupattelli,
Michael Sharland,
Carlo Giaquinto,
Yingfen Hsia,
Daniele Doná
Affiliations
Elisa Barbieri
Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
Cecilia Liberati
Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
Anna Cantarutti
Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
Costanza Di Chiara
Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
Angela Lupattelli
PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, University of Oslo, 0316 Oslo, Norway
Michael Sharland
PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, University of Oslo, 0316 Oslo, Norway
Carlo Giaquinto
Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
Yingfen Hsia
Centre for Neonatal and Paediatric Infection, St George’s University of London, London SW17 0RE, UK
Daniele Doná
Division of Paediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35100 Padua, Italy
The containment measures following COVID-19 pandemic drastically reduced airway infections, but they also limited the access of patients to healthcare services. We aimed to assess the antibiotic prescription patterns in the Italian paediatric primary care setting before and after the containment measures implementation. For this retrospective analysis, we used a population database, Pedianet, collecting data of patients aged 0–14 years enrolled with family paediatricians (FP) from March 2019 to March 2021. Antibiotic prescriptions were classified according to WHO AWaRe classification. An interrupted time series evaluating the impact of the containment measures implementation on the monthly antibiotic index, on the access to watch index, and on the amoxicillin to co-amoxiclav index stratified by diagnosis was performed. Overall, 121,304 antibiotic prescriptions were retrieved from 134 FP, for a total of 162,260 children. From March 2020, the antibiotic index dropped by more than 80% for respiratory infections. The Access to Watch trend did not change after the containment measures, reflecting the propensity to prescribe more broad-spectrum antibiotics for respiratory infections even during the pandemic. Similarly, co-amoxiclav was prescribed more often than amoxicillin alone for all the diagnoses, with a significant variation in the trend slope for upper respiratory tract infections prescriptions.
