Drug prescribing by Italian family paediatricians: an exception?

Aims: To identify which drugs are considered 'essential' by Italian family paediatricians based on their prescriptions. Methods: Prescriptions reimbursed by the National Health System, involving 923 177 children < 14 years old, and dispensed during 2005 by the retail pharmacies of 15 local health units (LHUs) in the Lombardy Region, were analysed. The percentage of family paediatricians prescribing each single drug was calculated. A percentage >= 75% was considered as a high degree of agreement. Results: In all, 746 different drugs were prescribed to 486 405 children (52.7%). The median number of drugs prescribed by each paediatrician was 60 (interquartile range 51-71). A total of 22 drugs were prescribed by at least 75% of paediatricians and six were prescribed by all the paediatricians. In all, 95% of the paediatricians prescribed four or more cephalosporins and 92% prescribed four inhaled steroids. Only eight of the 22 most frequent drugs are included in the World Health Organization Essential Medicines for children list. Conclusion: Despite the huge number of drugs prescribed, only for 22 there was a concordance between family paediatricians. Initiatives to evaluate and promote a more rational use of drugs in Italian children are necessary.