Impact of bronchiolitis guidelines publication on primary care prescriptions in the Italian pediatric population

NPJ Prim Care Respir Med. 2021 Mar 19;31(1):15. doi: 10.1038/s41533-021-00228-w.

Abstract

In Italy, two clinical practice guidelines for the diagnosis and treatment of bronchiolitis were published in October 2014 and December 2015. We evaluated prescriptions for bronchiolitis in children aged 0-24 months before (December 2012-December 2014), in between (December 2014-December 2015) and after (December 2015-December 2018) the guidelines publications. Data were retrieved from the Pedianet database; the measured outcomes were prescriptions rates of antibiotics, corticosteroids, β2-agonists, and other respiratory drugs. In 1011 out of 1581 episodes, patients received at least one treatment, with a total of 2003 prescriptions. The rate of treated bronchiolitis decreased from 66% to 57% (p < 0.001) after the publication of the second guideline; the highest reduction was in younger patients (from 57% to 44%, p = 0.013). Overall antibiotic prescriptions rate did not change, with 31.6% of the patients still receiving them. Our results confirm unnecessary non-evidence-based treatments in the primary care setting, with few changes after the guidelines publications.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bronchiolitis* / drug therapy
  • Child
  • Hospitalization
  • Humans
  • Infant
  • Italy
  • Practice Patterns, Physicians'*
  • Prescriptions
  • Primary Health Care

Substances

  • Anti-Bacterial Agents