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Appropriateness of antibiotic prescriptions in community-acquired acute pediatric respiratory infections in Spanish emergency rooms
- Source :
- Scopus-Elsevier
- Publication Year :
- 2001
-
Abstract
- Objective. To describe the variability and appropriateness of antibiotic prescriptions in community-acquired acute respiratory infections (ARI) during childhood in Spain. Methods. A descriptive, multicenter study of variability in clinical practice was conducted by evaluating a prospective series of pediatric patients attending the emergency rooms of 11 Spanish hospitals and diagnosed with community-acquired ARI. The appropriateness of the antibiotic prescriptions was assessed by comparing our clinical practice with consensus guidelines developed for this study. Results. We collected data from 6,249 ARI emergencies studied on 30 separate days. Antibiotics were prescribed in 58.7% of the ARI (bronchiolitis, 11.5%; bronchitis, 40.2%; pharyngotonsillitis, 80.9%; nonspecified ARI, 34.8%; pneumonia, 92.4%; otitis, 93.4%; sinusitis, 92.6%). The most commonly used antibiotics were amoxicillin/ clavulanate (33.2%), amoxicillin (30.2%), cefuroxime axetil (8.5%) and azithromycin (6%). According to the consensus guidelines developed for this study, therapy was considered to be appropriate in 63.1% of the ARI (first choice, 52.1%; alternative choice, 11.0%) and inappropriate in 36.9%. The percentages of inappropriate prescription according to ARI groups were: bronchiolitis, 11.5%; bronchitis, 31.5%; pharyngotonsillitis, 54.8%; nonspecified ARI, 34.7%; pneumonia, 13.9%; otitis, 25.6%; and sinusitis, 22.2%. Conclusions. There is excessive use of antibiotics in acute respiratory infections that are presumably viral in origin. An important number of ARI of potentially bacterial origin are treated with antibiotics that are not sufficiently efficacious or that have a broader spectrum than necessary.
- Subjects :
- Microbiology (medical)
Male
medicine.medical_specialty
Adolescent
Azithromycin
Internal medicine
medicine
Humans
Practice Patterns, Physicians'
Sinusitis
Intensive care medicine
Child
Respiratory Tract Infections
business.industry
Infant, Newborn
Infant
Amoxicillin
medicine.disease
respiratory tract diseases
Anti-Bacterial Agents
Community-Acquired Infections
Pneumonia
Infectious Diseases
Otitis
Cross-Sectional Studies
Bronchiolitis
Spain
Child, Preschool
Pediatrics, Perinatology and Child Health
Acute Disease
Bronchitis
Female
medicine.symptom
business
Emergency Service, Hospital
Cefuroxime
medicine.drug
Subjects
Details
- ISSN :
- 08913668
- Volume :
- 20
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- The Pediatric infectious disease journal
- Accession number :
- edsair.doi.dedup.....386c4f4cfa645fa73c609d67c42a9f4a