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Prescribing practices that promote antibiotic resistance: strategies for change
1Graduate School of Nursing, Boston College, Chestnut Hill, MA, USA.
Abstract:
Approximately 90% of all upper respiratory infections are caused by viruses, yet antibiotics are prescribed for 50% to 70% of patients who seek medical care for these conditions (Neiderman, Skerrett, & Yamauchi, 1998). Prescribing antibiotics for conditions for which there is no proven benefit is not a harmless practice; it contributes to the development of antibiotic resistance (Ware, 2000). This article will discuss the magnitude of the problem of antibiotic resistance as it relates to pediatric outpatient upper respiratory tract infection and otitis media, analyze practitioner prescribing practices that contribute to widespread antibiotic use, and suggest provider and patient intervention to improve the rational use of antibiotics.
Insights
Antibiotic resistance is a growing problem, especially in children with respiratory infections. Overuse of antibiotics for viral illnesses contributes to this public health threat, necessitating interventions for rational prescribing.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Public health
Background:
- Viral infections cause approximately 90% of upper respiratory tract infections.
- Antibiotics are inappropriately prescribed in 50-70% of pediatric outpatient visits for these conditions.
- Inappropriate antibiotic use fuels the development of antimicrobial resistance.
Purpose of the Study:
- To examine the scope of antibiotic resistance in pediatric upper respiratory tract infections and otitis media.
- To analyze prescribing practices contributing to excessive antibiotic use.
- To propose interventions for improving rational antibiotic prescribing.
Main Methods:
- Literature review on antibiotic resistance and prescribing patterns.
- Analysis of pediatric outpatient data for upper respiratory tract infections and otitis media.
- Synthesis of evidence for provider and patient interventions.
Main Results:
- High rates of antibiotic prescription for viral infections.
- Significant contribution of prescribing practices to antibiotic overuse.
- Identification of key areas for intervention.
Conclusions:
- Antibiotic resistance is a significant concern in pediatric respiratory infections.
- Current prescribing practices require modification to improve rational antibiotic use.
- Provider and patient education are crucial for combating antibiotic resistance.