Control of antibiotic therapy in paediatric patients. II. Appropriateness of antibiotic choice in selected diseases.

The adequacy of antibiotic choice and the importance of the physician's knowledge of antibiotic use in causing errors in prescribing were investigated. A prospective three-month study was conducted in nine Italian pediatric hospital wards, involving every patient admitted to hospital for otitis, pneumonia or pharyngotonsillitis. The suspected aetiology and the antibiotic prescribed were recorded on a special form by the physician in charge. Each choice of antimicrobial agent was judged as adequate, justifiable or not justified. Out of 314 prescriptions 56.1% were assessed as adequate, 4.1% as justifiable and 39.8% as not justified. Analysis of the suspected bacteria, and of the correlation between the presumed aetiological agent and the prescribed antibiotic, demonstrates that inadequate knowledge of the physician plays a major role in producing a high percentage of unjustified prescriptions.