In-label and off-label use of respiratory drugs in the Italian paediatric population.
OBJECTIVE
To evaluate the prescription rate of respiratory drugs (ATC code R03) in an Italian community setting and to estimate the extent of off-label use by both age and indication.


METHODS
A cohort study aimed at evaluating prescriptions of drugs with ATC code R03 was conducted for the period 2002-2006. Data source was the PEDIANET Database.


RESULTS
Ninety percent of R03 prescriptions are covered by 11 active substances or combinations, corresponding to 67 medicinal products. Inhaled corticosteroids are the most prescribed anti-asthmatic agents, followed by short-acting beta2 mimetics. The mean off-label rate is 19 and 56%, by age and indication respectively. The majority of off-label uses is among children under the age of 2. Five active substances are used at dosages not supported by adequate dose-finding studies.


CONCLUSIONS
In Italy, many respiratory drugs are approved for the treatment of paediatric respiratory diseases, but a remarkable percentage of their prescriptions is off-label. This pharmaco-utilization study demonstrates that there is a need to perform clinical studies aimed at increasing the current knowledge on marketed paediatric drugs, and to revise and re-label the existing regulatory documents to reduce their off-label uses.
Baiardi
P
P
Consorzio per Valutazioni Biologiche e Farmacologiche, Pavia, Italy. baraldi@pediatria.unipd.it
Ceci
A
A
Felisi
M
M
Cantarutti
L
L
Girotto
S
S
Sturkenboom
M
M
Baraldi
E
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017723:Drug Utilization Review; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D056687:Off-Label Use / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000627:therapeutic use*; D019141:Respiratory System Agents / Q000627:therapeutic use*
D055553:Prescription Drugs; D019141:Respiratory System Agents