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Background: Respiratory tract infections (RTI) in children is the most common cause of prescription of antibiotics. It is important to describe and analyse non-medical factors in order to develop more rational use of antibiotics., Objectives: To compare families with high and low concern about infectious illness with regard to social variables, perception of infection proneness and beliefs in antibiotics and to relate the concern for infectious illness to reported morbidity, physician consultations and antibiotic prescriptions for the 18-month-old child in the family., Methods: A prospective, population-based survey was performed. During 1 month, all infectious symptoms, physician consultations and antibiotic treatments for 18-month-old children were noted. The 818 families also answered questions about their socio-economic situation, illness perception and concern about infectious illness., Results: High concern about infectious illness was associated with more frequent physicians consultations and more prescriptions of antibiotics. There was no significant difference in reported days with symptoms of RTI, but the parents more often experienced their children with RTI without fever as being ill. The variables of infection proneness in the child, inadequate beliefs in antibiotics and the factor of being the only child were important explanatory factors for concern about infectious illness., Conclusions: High concern about infectious illness is an important determining factor for physician consultations and antibiotic prescription for small children. An adequate consultation, where the doctor deals with the parents' worries and gives appropriate information about symptoms and disease, might contribute to less antibiotic prescribing with preserved parental satisfaction.

Background: Daycare infants have more infectious episodes, see a physician more often, and are prescribed antibiotics more often than home care infants., Aim: To compare physician consultations and antibiotic prescription in daycare children and home care children taking number of symptom days, sociodemographic factors, concern about infectious illness and antibiotic knowledge into account., Methods: For a cohort of Swedish 18-month-old children all infectious symptoms, physician consultation and antibiotic prescriptions were registered during 1 month., Results: 561 infants with daycare outside the home and 278 with daycare at home were included. Of the daycare infants, 23.2% saw a physician and 11.4% were prescribed antibiotics, as compared with 10.8% physician consultations and 5.0% antibiotic prescription for the home care infants. For daycare infants the crude odds ratio for physician consultation were 2.49 (1.63-3.82) and for antibiotic prescription 2.43 (1.34-4.41) compared with home care infants. However, these differences were no longer statistically significant when background data, concern about infectious illness and reported symptoms were taken into account., Conclusion: When background data, concern about infectious illness and reported infectious symptoms were taken into account daycare infants saw a physician and was prescribed antibiotics in the same way as home care infants.

Background: Respiratory tract infections are the most common reason for antibiotic prescription in Sweden as in other countries. The prescription rates vary markedly in different countries, counties and municipalities. The reasons for these variations in prescription rate are not obvious., Aim: To find possible explanations for different antibiotic prescription rates in children., Design of Study: Prospective population based study., Setting: All child health clinics in four municipalities in Sweden which, according to official statistics, had high antibiotic prescription rates, and all child health clinics in three municipalities which had low antibiotic prescription rates., Method: During one month, parents recorded all infectious symptoms, physician consultations and antibiotic treatments, from 848 18-month-old children in a log book. The parents also answered a questionnaire about socioeconomic factors and concern about infectious diseases., Results: Antibiotics were prescribed to 11.6% of the children in the high prescription area and 4.7% in the low prescription area during the study month (crude odds ratio [OR] = 2.67; 95% confidence interval [CI] = 1.45 to 4.93). After multiple logistic regression analyses taking account of socioeconomic factors, concern about infectious illness, number of symptom days and physician consultations, differences in antibiotic prescription rates remained (adjusted OR = 2.61; 95% CI = 1.14 to 5.98). The variable that impacted most on antibiotic prescription rates, although it was not relevant to the geographical differences, was a high level of concern about infectious illness in the family., Conclusions: The differences in antibiotic prescription rates could not be explained by socioeconomic factors, concern about infectious illness, number of symptom days and physician consultations. The differences may be attributable to different prescription behaviour.

Streptomyces halstedii K122 was previously found to produce antifungal compounds on solid substrates that inhibit radial growth of fungi among Ascomycetes, Basidiomycetes, Deuteromycetes, Oomycetes, and Zygomycetes, and strongly affected hyphal branching and morphology. During growth of S. halstedii K122 in submerged culture, no antifungal activity could be detected. However, cultivation of S. halstedii in thin (1 mm) liquid substrate layers in large surface-area tissue culture flasks caused intense growth and sporulation of S. halstedii K122, and the biologically active compounds could be extracted from the mycelium with methanol. Antifungal compounds were purified using C18 solid phase extraction and silica gel column chromatography, and identified as bafilomycins B1 and C1, using 2D NMR and FAB MS. Production of bafilomycins, which are specific inhibitors of vacuolar ATPases, has not been reported from S. halstedii previously. Minimum inhibitory concentrations (MIC) of bafilomycins B1 and C1, amphotericin B, and nikkomycin Z were determined at pH 5.5 and 7.0 for the target fungi Aspergillus fumigatus, Mucor hiemalis, Penicillium roqueforti, and Paecilomyces variotii. Penicillium roqueforti was the most sensitive species to all the compounds investigated. The MIC values for amphotericin B were 0.5-4 micrograms.mL-1 for the fungi tested, and pH did not affect the toxicity. The MIC values for nikkomycin Z ranged from < 0.5 microgram.mL-1 for Mucor hiemalis to > 500 micrograms.mL-1 for Aspergillus fumigatus, and pH had no influence on toxicity. Bafilomycins B1 and C1 were equally active against the fungal species tested, with MIC values in the range of < 0.5-64 micrograms.mL-1. All fungi were more sensitive to both bafilomycin B1 and C1 at pH 7.0 than at pH 5.5.

In a geographically well defined population in southern Sweden, a study was made of the overall consumption of drugs by infants during their first 18 months of life. The study population comprised 240 infants, of whom 90 were from families where tobacco was smoked by one or both parents and 150 were from non-smoking families. The investigation was carried out retrospectively by interviewing the mothers at the routine 18-month check up at the child health clinic, combined with study of the medical records at the district health centre, and at the paediatric and ear, nose and throat departments of the nearby hospital. In addition, the reliability of the interview method compared with review of medical records was investigated. Particular attention was paid to the consumption of antibiotics and the relationship between 'passive smoking' and consumption of antibiotics necessitated by respiratory tract infections. There was widespread use of both prescribed and non-prescription remedies. At the age of 18 months, about two thirds of all infants in the area had been prescribed an antibiotic (or other antibacterial agent) on at least one occasion. Infants from smoking families had been prescribed significantly more antibiotics than had infants from non-smoking families. The same pattern was also apparent for nose drops and dimethicone/dicyclomine hydrochloride. The incidence of respiratory tract infections requiring antibiotic treatment was higher in infants from smoking families than from non-smoking families in all the three-month age groups up to 15 months. The responses to the retrospective interview accorded closely with the details recorded in the medical records.(ABSTRACT TRUNCATED AT 250 WORDS)

During the 9-month period September 1986-May 1987, reasons for absence and antibiotic consumption were investigated among children cared for in day-care center(s) (DCC) and Swedish town. family day-care (FDC) within a limited geographical area of a medium-sized Swedish town. All 352 children in 11 DCC in this area and 199 children in FDC were included in this prospective study, which intended to elucidate the infectious morbidity. The investigation period comprised 55,760 and 26,019 expected days' attendance for the DCC and FDC children, respectively. A higher absence attributable to infection was evident at all ages in DCC children than in those in FDC. This difference tended to diminish with age. No difference in antibiotic consumption was evident between the 2 categories, and the diagnostic pattern was almost identical. In the DCC, overall absence figures, and absence due to infection, were considerably lower than in earlier comparable studies. Appreciable differences in absence due to infection and antibiotic consumption were also found between different "departments" in the DCC; both low and high-absence groups could be identified. There was an indication of differences between the groups both socially and in the environment at the DCC.