Rational use of antimicrobials in the treatment of upper airway infections
Santiago Alfayate Miguélez1, Luis Garcia-Marcos2
1Universidad de Murcia, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Department of Pediatrics, Infections Unit, Murcia, Spain.
Insights
Reducing antibiotic misuse in children with upper airway infections requires prescriber training, patient education, and trust. Public health initiatives should also target animal and environmental antibiotic use.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance is a growing global threat.
- Upper airway respiratory infections (UARIs) are common in children and often viral.
- Inappropriate antibiotic prescribing for UARIs contributes to resistance.
Purpose of the Study:
- To identify the primary drivers of antibiotic misuse in pediatric UARIs.
- To evaluate effective strategies for reducing unnecessary antibiotic prescriptions in children.
Main Methods:
- Systematic literature search across multiple databases.
- Inclusion of studies on antibiotic resistance, UARIs, and pediatric patients.
- Analysis of intervention effectiveness and influencing factors.
Main Results:
- Multi-faceted interventions are more effective than single strategies.
- Key elements include prescriber training (technical and communication skills), adequate patient time, and patient/parent education.
- Deferred prescribing and rapid diagnostic tests show promise in primary care.
- Trust-based clinician-parent relationships are crucial.
Conclusions:
- Comprehensive strategies are needed to combat antibiotic misuse.
- Involvement of health authorities is essential for implementing and enforcing measures.
- Reducing antibiotic use in animals and the environment is critical.
- Further research into novel antimicrobials is necessary.
Objective:
To analyze the main cause of the irresponsible use of antibiotics at the pediatric level in a very frequent, usually self-limited, and typically viral condition: upper airway respiratory infections.
Sources:
Different databases were searched using specific terms related to resistance to antibiotics, upper airway respiratory infections, and pediatrics patients.
Summary Of The Findings:
Effectiveness varies depending on the place, the form of intervention, and the resources used. Multiple interventions appear to be more effective. The foundations of treatment are training in technical aspects and in communication skills for the prescribers, and having enough time for each patient; and training through the health clinic and the media for patients/parents. Deferred prescription and the use of rapid diagnostic tests in the primary care setting have been shown to be effective. A fluid relationship based on trust between clinicians and parents/guardians is one of the keystones.
Conclusions:
Any project that seeks to be totally effective must include a health authority, which in addition to helping implement these measures, has the firm intention of drastically reducing the use of antibiotics in animals and in the environment, as well as favoring research into new antimicrobials.
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