title: Comparing recurrent antibiotic prescriptions in children treated with a brand name or a generic formulation.
abstract: OBJECTIVE
  The aim of this study was to investigate the rate of recurrent prescriptions and hospital admissions in children receiving a brand name or generic antibiotic prescription.
  
  
  METHODS
  The data source was a database of reimbursed prescriptions. Outpatient children/adolescents <18 years old (Lombardy Region, Italy) were included. The observational period was February-April 2010. A recurrence was defined as an antibiotic prescription occurring within 28 days after an index prescription. The rate of recurrent prescriptions and hospital admissions was calculated for generic/brand name formulations and for each age strata (0-5, 6-11, and 12-17 years old) for four antibiotics: amoxicillin, amoxicillin clavulanate, clarithromycin, and cefaclor. The percentage of therapy switches was calculated. Cochran-Mantel-Haenszel test was used to compare the age-adjusted outcomes.
  
  
  RESULTS
  In all, 17.5% (57 346) of children received at least one recurrent prescription. The rate of recurrent prescriptions was slightly lower in children receiving any generic (OR 0.96; 95%CI 0.93-0.98), compared with any brand name, antibiotic. The percentage of hospital admissions occurring in children initially treated with a brand name (1.01%; 95%CI 0.98-1.08) or generic (1.03%; 0.96-1.06) antibiotic was not different (p = 0.43). For children receiving amoxicillin clavulanate, the hospital admission rate was slightly higher in the brand name group (p = 0.002), while no differences were found for the other active substances.
  
  
  CONCLUSIONS
  Children treated with generic antibiotics had no worse safety and effectiveness outcomes when compared with those receiving brand name ones. These results provide additional evidence on the safety of generic antibiotics.
authors.affiliation: Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Piovani
authors.forename: Antonio
authors.initials: A
authors.lastname: Clavenna
authors.forename: Massimo
authors.initials: M
authors.lastname: Cartabia
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bonati
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016568:Drugs, Generic; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007558:Italy; D055656:Prescriptions; D013810:Therapeutic Equivalency
chemical_list: D000900:Anti-Bacterial Agents; D016568:Drugs, Generic
keywords: anti-bacterial agents; child; drug utilisation; drugs, generic; pharmacoepidemiology; prescriptions; recurrence