Antibiotic Prescriptions for Children With Community-acquired Pneumonia: Findings From Italy.

INTRODUCTION AND OBJECTIVE: Community-acquired pneumonia (CAP) is one of the most common reasons of prescribing antibiotics for children, often with overuse of broad-spectrum antibiotics. The aim of this study is to describe the antibiotic prescriptions for Italian children with CAP, at the primary care level. STUDY DESIGN: Retrospective cohort study conducted among children 3 months-14 years of age with CAP, enrolled in Pedianet (http://www.pedianet.it) from January 1, 2009 to December 31, 2018. Antibiotic treatment was defined as narrow-spectrum (NS-ABT) if amoxicillin and broad-spectrum (BS-ABT) if amoxicillin/clavulanic acid, cephalosporins or any combination. Crude and adjusted logistic regressions for the odds of receiving NS-ABT were conducted (all episodes of CAP and per patient). A P value <0.05 was considered statistically significant. RESULTS: Among 9691 CAP, 7260 episodes from 6409 children followed by 147 pediatricians were analyzed. The 16.7% of CAP [1216/7260, 95% confidence interval (CI): 15.9%-17.6%] received an NS-ABT while 53.3% (3863/7260, 95% CI: 52%-54.4%) received BS-ABTs and 30% (2181/7260, 95% CI: 28.9%-31.1%) macrolides. Within 10 years, a slight but increasing trend of NS-ABT prescription was observed (P < 0.001). Factors independently associated with reduced odds of receiving an NS-ABT compared with BS-ABT including macrolides were being older than 5 years [odds ratio (OR) 0.45, 95% CI: 0.39-0.52], living in Central/Southern Italy (OR 0.13, 95% CI: 0.10-0.16) and being exposed to ABT 3 months before (OR 0.61, 95% CI: 0.53-0.70). These findings were confirmed comparing NS-ABT versus BS-ABT excluding macrolides (n = 5079) and when the analysis was limited to index CAP. CONCLUSION: Our findings report a very limited prescription of narrow-spectrum antibiotics for Italian children with CAP.

Kinematic bidimensional analysis of the propulsion technique in wheelchair rugby athletes.

Wheelchair rugby is a sport ideated for individuals with cervical spinal cord injury (CSCI) which is extremely important for maintaining their neuromuscular abilities and improving their social and psychological wellbeing. However, due to the frequent changes in direction and speed it considerably stresses the players' upper limbs. 13 athletes have undergone two sports-related tests on an inertial drum bench and several kinematic parameters have been registered. Most athletes use a semi-circular pattern which is considered protective for the upper limb. With increasing speed, range of motion (ROM) increases. Release angles increment and contact angles reduce, displacing the push angle forward to increase speed. Instead, the more anterior late push angle used to increase velocity is a factor which further loads the shoulder joint. However, other factors affecting propulsion technique, such as posture and wheelchair set up should be studied to further reduce loading on the upper limb.