Sadozai et al reported the POPI tool (Pediatrics: Omission of Prescriptions and Inappropriate Prescriptions) for problematic therapies for pediatric patient. Categories included management of skin disorders and insects. The authors are from multiple institutions in Paris.
Patient selection: pediatric patients
Categories:
(1) acne vulgaris
(2) ringworm
(3) impetigo
(4) HSV
(5) atopic dermatitis
(6) mosquito bites
(7) scabies
Inappropriate prescriptions:
(1) Citonella essential oil to prevent mosquito bites
(2) anti-insect bracelet
(3) ultrasonic pet control devices, vitamin B1, homeopathy, electric bug zapper, sticky tape to control mosquitoes
(4) isoretinoin in combination with a tetracycline class antibiotic for acne vulgaris
(5) combination of oral and topical antibiotic for acne vulgaris
(6) oral or topical antibiotic as monotherapy for acne vulgaris
(7) topical corticosteroids for Herpes simplex
(8) strong dermocortioid applied to face, axilla, groin and buttocks of an infant or child with atopic eczema
(9) more than 1 application per day of dermocorticoid in mild or moderate atopic eczema
(10) local or systemic antihistamine during an outbreak of atopic dermatitis
(11) topical 0.03% tacrolimus before 2 years of age for atopic eczema
(12) topical 0.1% tacrolimus before 16 years of age for atopic eczema
(13) oral corticosteroids to treat outbreaks of atopic eczema
Therapeutic omissions:
(1) mosquito nets and clothes treated with pyrethroids in mosquito season
(2) giving a second dose of ivermectin 2 weeks after the first in a patient with scabies
(3) decontamination household linen and clothes in a patient with scabies
(4) treating other family members in a patient with scabies
(5) topical combined with oral antibiotic for ringworm
(6) topical combined with oral antibiotic for impetigo
(7) acetaminophen during an outbreak of Herpes simplex
(8) oral acyclovir to treat primary herpetic gingivostomatitis
