[Survey of the judicious use of antibiotics in primary care]
C Casaní Martínez1, F Calvo Rigual, A Peris Vidal
1Centro de Salud de Segorbe y Soneja. Castellón. España. camarcar@alumni.uv.es
Insights
Pediatricians frequently prescribe antibiotics for acute otitis media and tonsillopharyngitis. Reducing pediatrician workload and educating parents can decrease inappropriate antibiotic use.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Context:
- Antibiotic prescribing patterns for common pediatric infections vary significantly.
- Understanding parent-pediatrician interactions is crucial for optimizing antimicrobial stewardship.
- The Autonomous Community of Valencia, Spain, serves as the study setting.
Purpose:
- To investigate pediatricians' antibiotic prescribing habits for acute otitis media and tonsillopharyngitis.
- To analyze the dynamics between parents and pediatricians regarding antibiotic prescriptions.
- To identify factors contributing to inappropriate antibiotic use in pediatric care.
Summary:
- A survey of 143 pediatricians in Valencia revealed frequent antibiotic use for acute otitis media, with amoxicillin-clavulanate being most common.
- For tonsillopharyngitis, amoxicillin was the preferred antibiotic, with less than 10% prescribing empirically.
- Excess workload was identified as a key reason for inappropriate antibiotic prescribing.
Impact:
- Findings highlight the need for targeted interventions to improve antibiotic prescribing practices in pediatric settings.
- Health education for parents and workload reduction for pediatricians are recommended strategies to curb antimicrobial resistance.
- This study provides valuable insights for developing evidence-based guidelines for managing common pediatric infections.
Objective:
To identify pediatricians' antibiotic prescribing habits in acute otitis media and tonsillopharyngitis and to determine the interaction between parents and pediatricians concerning antibiotic use in the Autonomous Community of Valencia (Spain).
Method:
Four hundred members of the Valencian Society of Pediatrics were randomly selected. A semi-structured questionnaire with non-excluding answers was sent by mail and, when responses were not obtained, a second one was sent. The confidentiality of the information was guaranteed.
Results:
Of 400 questionnaires sent, 143 (35.8 %) were completed; 88.1 % were completed by pediatricians and 51.1 % by primary care workers. A total of 48.3 % of pediatricians used antibiotics in all cases of acute otitis media and 94.5 % prescribed them when fever and otalgia persisted for more than 48 hours. Amoxicillin-clavulanate was the most frequently prescribed antibiotic (63.6 %). Less than 10 % of pediatricians prescribed antibiotics as empirical treatment in tonsillopharyngitis; amoxicillin was the most frequently prescribed antibiotic (54.6 %). Indications for antibiotic treatment were fever, odynophagia and adenomegaly (69.5 %) and tonsillar exudate (62.5 %). Inappropriate antibiotic use was mainly due to excess workload. Providing health education to parents could be the best way of reducing inappropriate use.
Conclusions:
Antibiotic use is frequent in the treatment of acute otitis media. Amoxicillin-clavulanate and amoxicillin were the most frequently prescribed antibiotics in tonsillopharyngitis. Providing health education to parents and reducing pediatricians' workload would decrease inappropriate antibiotic use.
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