title: Prescribers' indications for drugs in childhood: a survey of five European countries (Spain, France, Bulgaria, Slovakia and Russia).
abstract: BACKGROUND
  Indication-based, in comparison to diagnoses-based, drug utilization studies in children are scarce in the literature.
  
  
  OBJECTIVE
  To determine the adequacy of the prescriber's indications for specific drug treatments compared to the current literature in five different European countries; and to show the possibilities of performing indication-based drug utilization studies.
  
  
  METHODS
  a descriptive, cross-sectional, international study.
  
  
  METHODS
  Randomly selected sample of 12,264 paediatric outpatients seen in consultation rooms attended by paediatricians or general practitioners. Data on patient demographics, diagnoses, and pharmacological treatment, with therapeutic indications for each drug, were collected in pre-designed forms. Diagnoses and indications were coded using the ICD-9 and drugs according to the ATC classifications.
  
  
  RESULTS
  Indications were registered for every drug prescribed in all locations. Antibiotic indications considered incorrect (common cold, upper respiratory tract infections, viral infections, general symptoms or "not specified") accounted from 24.1% of the total antibiotics prescribed in Tenerife to 67.4% in Slovakia. Incorrect indication of first-choice antibiotics prescribed in acute otitis media and tonsillitis ranged from 28.9% of total antibiotics use in Russia to 75.4% in Tenerife. Correct antibiotic indications ranged from 23.4% of total antibiotics used in Slovakia to 65.7% in Tenerife. Aspirin use in febrile viral conditions was detected mainly in Toulouse and Russia.
  
  
  CONCLUSIONS
  The main areas for improvement detected were high use of mucolytics, prescription of aspirin in potential or established viral infections, overuse of antibiotics and identification of specific patterns of incorrect antibiotic prescription and clinical entities associated with each location.
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, University of La Laguna, La Laguna, Tenerife, Spain. esanz@ull.es
authors.forename: Emilio J
authors.initials: EJ
authors.lastname: Sanz
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Hernández
authors.forename: Svetla
authors.initials: S
authors.lastname: Ratchina
authors.forename: Leonid
authors.initials: L
authors.lastname: Stratchounsky
authors.forename: Maria Asuncion
authors.initials: MA
authors.lastname: Peiré
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre Mestre
authors.forename: Bernard
authors.initials: B
authors.lastname: Horen
authors.forename: Milan
authors.initials: M
authors.lastname: Kriska
authors.forename: Halina
authors.initials: H
authors.lastname: Krajnakova
authors.forename: Hristina
authors.initials: H
authors.lastname: Momcheva
authors.forename: Daniela
authors.initials: D
authors.lastname: Encheva
authors.forename: Inocencia
authors.initials: I
authors.lastname: Martínez-Mir
authors.forename: Vicente
authors.initials: V
authors.lastname: Palop
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002031:Bulgaria; D002648:Child; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005100:Expectorants / Q000627:therapeutic use; D005602:France; D019538:Health Care Surveys; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012426:Russia; D018154:Slovakia; D013030:Spain; D014069:Tonsillitis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D005100:Expectorants