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Rational use of oral antibiotics for pediatric infections
1Dept. of Pediatrics, Second Tokyo National Hospital, Japan.
Insights
In Japan, about 25% of children don't complete their oral antibiotic courses due to perceived cure, refusal, or side effects. This impacts pediatric respiratory infection treatment effectiveness.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial stewardship
- Clinical pharmacy
Background:
- Antibiotic non-compliance in children is a global concern.
- Oral antibiotics are frequently prescribed for pediatric respiratory infections.
- Understanding reasons for non-compliance is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To investigate antibiotic compliance rates among children in Japan.
- To identify reasons for premature discontinuation of oral antibiotics.
- To evaluate oral antibiotic characteristics relevant to pediatric use.
Main Methods:
- A survey was conducted in Japan focusing on pediatric outpatients receiving oral antibiotics.
- Data collected included reasons for non-compliance and antibiotic administration factors.
- Beta-lactam antibiotics were compared with other oral agents for respiratory infections.
Main Results:
- Approximately one-quarter of pediatric patients in Japan did not complete their prescribed antibiotic course.
- Common reasons for discontinuation included perceived cure, child refusal, and adverse effects.
- Factors like ease of administration, side effects (especially diarrhea), dosage form, taste, and frequency were assessed.
Conclusions:
- Suboptimal antibiotic compliance is prevalent in Japanese pediatric outpatients.
- Addressing parental judgment, child refusal, and side effects is key to improving adherence.
- Antibiotic selection should consider administration factors critical for pediatric compliance.
Abstract:
We carried out a survey in Japan to investigate compliance among children given oral antibiotics in an outpatient setting. The results of our survey revealed that, in Japan, approximately one-quarter of patients did not take their full course of antibiotics. Reasons for unsupervised self-discontinuation included: (1) the parent or guardian judged the infection to be cured; (2) the child refused to take the drug; and (3) the appearance of side effects. Causative organisms often involved in respiratory infections experienced in out-patient medicine include pneumococci, streptococci, staphylococci, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and Mycoplasma pneumoniae. The beta-lactams are effective against all of these bacterial species, with the exception of M. pneumoniae. We conducted a survey of beta-lactam antibiotics currently on the Japanese market and compared them to other oral antibiotics used to treat respiratory infections. Ease of administration, based on the incidence of adverse effects, particularly diarrhea, the dosage form, taste, dosage per administration and the number of doses required per day, are reported.