title: Rational use of antibiotics for the management of children's respiratory tract infections in the ambulatory setting: an evidence-based consensus by the Italian Society of Preventive and Social Pediatrics.
abstract: BACKGROUND
  Several guidelines for the management of respiratory tract infections in children are available in Italy, as well as in other European countries and the United States of America. However, poor adherence to guidelines and the sustained inappropriate use of antibiotics have been reported. In the outpatient setting, almost half of antibiotics are prescribed for the treatment of common respiratory tract infections. In Italy the antibiotic prescription rate is significantly higher than in other European countries, such as Denmark or the Netherlands, and also the levels of antibiotic resistance for a large variety of bacteria are higher. Therefore, the Italian Society of Preventive and Social Paediatrics organised a consensus conference for the treatment of respiratory tract infections in children to produce a brief, easily readable, evidence-based document.
  
  
  METHODS
  The conference method was used, according to the National Institute of Health and the National Plan Guidelines. A literature search was performed focusing on the current guidelines for the treatment of airway infections in children aged 1 month-18 years in the ambulatory setting.
  
  
  RESULTS
  Recommendations for the treatment of acute pharyngitis, acute otitis media, sinusitis, and pneumonia have been summarized. Conditions for which antibiotic treatment should not be routinely prescribed have been highlighted.
  
  
  CONCLUSIONS
  This evidence-based document is intended to accessible to primary care pediatricians and general practice physicians in order to make clinical practice uniform, in accordance with the recommendations of the current guidelines.
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Mazzantini
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Bruzzese
authors.affiliation: Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
authors.affiliation: Primary care Pediatrician, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Colombo
authors.affiliation: Health Search Institute, Italian College of General Practitioners, Florence, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cricelli
authors.affiliation: President Italian Society of Preventive and Social Pediatrics Primary care Pediatrician, Caserta, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Mauro
authors.affiliation: Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Festini
authors.affiliation: Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
authors.affiliation: Department of Pediatrics, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Vito Leonardo
authors.initials: VL
authors.lastname: Miniello
authors.affiliation: Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
authors.affiliation: Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.affiliation: Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Rafaniello
authors.affiliation: Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.affiliation: Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy.
authors.forename: Liberata
authors.initials: L
authors.lastname: Sportiello
authors.affiliation: Epidemiology Unit, AUSL Naples 1, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tancredi
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Venturini
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.affiliation: Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004363:Drug Utilization / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Children; Guidelines; Respiratory tract infections