TY - JOUR T1 - Assessing the quality of paediatric antibiotic prescribing by community paediatricians: a database analysis of prescribing in Lombardy JF - BMJ Paediatrics Open DO - 10.1136/bmjpo-2017-000169 VL - 1 IS - 1 SP - e000169 AU - Daniele Piovani AU - Antonio Clavenna AU - Massimo Cartabia AU - Angela Bortolotti AU - Ida Fortino AU - Luca Merlino AU - Maurizio Bonati Y1 - 2017/09/01 UR - http://bmjpaedsopen.bmj.com/content/1/1/e000169.abstract N2 - Objective To evaluate the quality of paediatricians’ antibiotic prescribing using administrative databases.Methods The data source was the database of reimbursed prescriptions of the Lombardy Region, Italy. Children 1–13 years were included. An index prescription was defined as the first antibiotic prescription during a year period (2011) that occurred without previous, recent, antibiotic prescriptions or hospital or emergency department admissions. The A indicator was the percentage of children, cared for by paediatricians, receiving amoxicillin at the index prescription (minimum target 50%). The B indicator was the percentage of children receiving exclusively non-penicillin antibiotics in unrelated infection episodes (maximum target 10%). Indicators were evaluated for each prescriber and geographical area.Results Overall 424 280 children (cared for by 1164 paediatricians) received an index prescription and were included in the study. Amoxicillin alone was prescribed at the index prescription only to 23.6% of children (7.9%–46.3% within different areas of the region).The percentage of paediatricians who reached the target for the quality indicators was low (12.8% A indicator; 54.0% B indicator; 11.3% both). Almost half of the paediatricians (44.5%) showed inadequate quality of antibiotic prescribing, failing to reach the target for both indicators. Quality of prescribing was about four times worse in high prescribers and younger paediatricians. A geographical cluster of paediatricians reaching the target for both indicators was identified. These paediatricians had, for several years, previously been involved in educational programme.Conclusions Quality of prescribing was generally unsatisfactory, but increased in a group of paediatricians previously involved in educational interventions and increased with increasing age. Further studies are warranted in order to validate these promising indicators as a benchmarking tool in other studies, when diagnosis is unknown. ER -