Antibiotic Usage for Treatment of Acute Upper Respiratory Tract Infections in Children in Lithuania from 2018 to 2022

Background/Objectives: Acute upper respiratory tract infections (URIs) are defined as inflammatory diseases of the nose, sinuses, pharynx, larynx, or trachea. They are common in children. The prescription of antibiotics for the treatment of URIs became a relevant theme in the scientific literature in recent decades. One of the most important ways to deal with increasing antimicrobial resistance is rational antibiotic therapy. This study aimed to evaluate the tendencies of antibiotic prescribing practices for Lithuanian children with URIs from 2018 to 2022. We describe how many children with URIs were prescribed antibiotics, which antibiotics were used, and whether prescribing practices meet national guidelines. Methods: Secondary data, which were used in this observational study, were collected from the Lithuanian Compulsory Health Insurance Fund (CHIF) electronic records. The study population consisted of children aged between 0 and 18 years who visited their primary care doctors (pediatricians or family doctors) between January 2018 and December 2022 and were prescribed antibiotics for the treatment of URIs. Results: Between 2018 and 2022, there were 445,328 visits reported when antibiotics, which belong to the J01 group according to the Anatomical Therapeutic Chemical Classification (ATC), were prescribed to children aged 0-18. In more than half of the visits (51.70%), children aged 0-5 were consulted. Penicillins were mostly prescribed for the treatment of acute nasopharyngitis. Macrolides were mostly used to treat acute laryngitis and tracheitis. Of all penicillin-class antibiotics, the most popular choice was amoxycillin. The primary choice of cephalosporin was cefadroxil, and the primary choice of macrolide was clarithromycin. Conclusions: During the period of 2018-2022, the number of prescriptions for antibiotics for URTIs decreased, but prescriptions for penicillin-class antibiotics increased in a relative manner. The most common diagnoses during these visits were acute tonsillitis and acute pharyngitis, and most antibiotic prescriptions were for children in the 0-5 age group. If Lithuania's National Recommendations on the Rational Use of Antibiotics were implemented during the analyzed period, the prescribing tendencies would not meet them.