Sadozai et al reported the POPI tool (Pediatrics: Omission of Prescriptions and Inappropriate Prescriptions) for problematic therapies for pediatric patient. Categories included several miscellaneous categories The authors are from multiple institutions in Paris.

Patient selection: pediatric patients



(1) ENT infection

(2) urinary tract infection (UTI)

(3) nocturnal enuresis

(4) fluoride supplementation


Inappropriate prescriptions:

(1) antibiotic prophylaxis after an initial UTI without complications (excluding uropathy)

(2) antibiotic prophylaxis with asymptomatic bacteriuria (except in the case of uropathy)

(3) fluoride supplements prior to 6 months of age

(4) antibiotic other than amoxicillin as first line treatment for acute otitis media, strept throat or sinusitis in a patient not allergic to penicillins

(5) antibiotic treatment for a sore throat without a positive rapid test for strept throat in a child less than 3 years old

(6) antibiotics for nasopharyngitis-congestive otitis-sore throat before 3 years of age

(7) antibiotics as first line treatment for acute otitis media showing few symptoms before 2 years of age

(8) antibiotics to treat otitis media with effusion (exceptions: hearing loss or otitis lasting more than 3 months)

(9) corticosteroids to treat acute suppurative otitis media, nasopharyngitis or strep throad

(10) nasal or oral decongestant (phenylephredine, etc)

(11) H1 antagonists with selective or atropine-like effects before 30 months of age

(12) camphor before 30 months of age

(13) menthol or any terpene derivative before 30 months of age

(14) ear drops in the case of acute otitis media

(15) desmopressin for nocturnal enuresis administered by a nasal spray

(16) desmopressin for daytime symptoms in a patient with nocturnal enuresis

(17) anticholinergic agent as monotherapy for nocturnal enuresis if there are no daytime symptoms

(18) tricyclic agent in combination with anticholinergic agents for nocturnal enuresis

(19) tricyclic agent as a first line treatment for nocturnal enuresis


Therapeutic omissions:

(1) acetaminophen combined with antibiotic to treat ear infection with pain

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