[Reported practices of antimicrobial use for upper respiratory tract infections]

To determine the reported antibiotic prescribing practices for upper respiratory tract infections in children among pediatricians and family physicians.

Regional survey of practicing pediatricians and family physicians and comparison of the survey responses of 81 physicians with the recently published recommendations of the Centers for Disease Control and Prevention.

Whereas almost all the physicians agreed that a diagnosis of acute otitis media required documentation of middle ear effusion and acute illness, 28% of family physicians and 12% of pediatricians reported that they routinely prescribed antibiotics for children with bronchitis, even though this is not recommended. In this survey 39% of pediatricians and 47% of family physicians reported that they omitted laboratory testing for the diagnosis of group A streptococcal pharyngitis, and of those who submitted samples for testing, most reported that they prescribed antibiotics immediately without waiting for the results. Even though these recommendations state that sinus tenderness is rare in young children with sinusitis, more than 48% of the physicians believed that both this and the presence of purulent rhinitis were essential to confirm this diagnosis. While none of the pediatricians reported prescribing antibiotics for the common cold, 17% of the family physicians did so (p = 0.006).

The reported prescribing practices of the physicians in this survey are not in line with the recommendations. Effective intervention is needed to encourage the judicious use of antibiotics in Israel.