Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, 20156, Italy.
BMC Pediatr. 2013 Apr 4;13:46. doi: 10.1186/1471-2431-13-46.
Large differences exist in the prevalence rate of drugs prescribed to children and adolescents between and within countries. The aim of this study was to evaluate child and adolescent drug prescription patterns in Italy in an extra-hospital setting at the regional and Local Health Unit (LHU) levels.
Data sources were three regional prescription databases. Data concerning the year 2008 were evaluated. A total of 3.3 million children and adolescents were included. Drug prevalence and prescription rates were evaluated at the regional and LHU levels. The correlation between mean latitude, average annual income, hospitalisation rate, number of paediatricians per 1,000 resident children, and prevalence rate was evaluated by LHU using a linear multiple regression analysis.
Large differences were found across Italian regions and LHUs. The mean prevalence rate was 56.4% (95% CI 56.3-56.5%; 51.2-65.4% among regions) and, at the LHU level, ranged from 43.1% to 70.0% (higher in the South). A total of 878 drugs were prescribed, 175 of which were shared by all LHUs. Amoxicillin clavulanate was the most used drug in all regions and in 31 of 33 LHUs. Amoxicillin was the drug with the highest variability in use between LHUs (9.1-52.1% of treated children). An inverse correlation was found between prevalence rate and both latitude (p < 0.0001) and average annual income (p = 0.0002).
The use of drugs in children and adolescents is higher in southern Italy and is inversely related to latitude and average annual income. More efforts should be devoted to informing physicians, patients and policy makers in order to plan effective initiatives to improve the situation.
国家之间和国家内部儿童和青少年用药的流行率存在很大差异。本研究旨在评估意大利在医院外环境下，在区域和地方卫生单位（LHU）层面儿童和青少年的药物处方模式。
数据来源为三个区域处方数据库。评估了 2008 年的数据。共纳入 330 万儿童和青少年。在区域和 LHU 层面评估药物流行率和处方率。通过 LHU 的线性多元回归分析，评估平均纬度、平均年收入、住院率、每千名居民儿童的儿科医生数量与流行率之间的相关性。
意大利各地区和 LHU 之间存在较大差异。平均流行率为 56.4%（95%CI 56.3-56.5%；51.2-65.4%），在 LHU 层面，范围从 43.1%到 70.0%（南部更高）。共开出 878 种药物，其中 175 种药物为所有 LHU 所共有。阿莫西林克拉维酸钾在所有地区和 33 个 LHU 中的 31 个中都是最常用的药物。阿莫西林是 LHU 之间使用差异最大的药物（9.1-52.1%的治疗儿童）。流行率与纬度（p < 0.0001）和平均年收入（p = 0.0002）呈负相关。
意大利南部地区儿童和青少年用药较高，与纬度和平均年收入呈负相关。应更加努力地向医生、患者和决策者提供信息，以规划有效的举措来改善这种情况。
