Antibiotic prescribing patterns in primary health care. Do pediatricians use antibiotics rationally?

• Published in: Anales españoles de pediatría Vol. 52; no. 2; p. 157
• Main Authors: Calvo Rey, C, Albañil Ballesteros, R, Sánchez Méndez, M Y, Olivas Domínguez, A
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.02.2000
• Subjects: Anti-Bacterial Agents - therapeutic use; Child, Preschool; Cross-Sectional Studies; Humans; Infant; Infant, Newborn; Pediatrics; Practice Patterns, Physicians; Primary Health Care; Retrospective Studies
• ISSN: 0302-4342

To determine antibiotic prescribing patterns in the pediatric (infants and children) population attended to at a primary health care centre in the community of Madrid. We also wanted to determine the necessity or otherwise of antibiotic therapy and whether the selected antibiotic drug was appropriate for the pathology diagnosed. Retrospective study of all infectious or respiratory processes diagnosed during 1 year and of the respective antibiotic cycles prescribed in all patients under the age of 4 years. The prescribing physician and the appropriateness of all therapeutic decisions, including those where the decision was not to treat with antibiotic drugs, were analyzed. We evaluated 910 children under the age of 4 years with a total of 3, 847 processes (mean of 4.55 +/-3.6 processes per child per year). Sixty-three percent of the children received at least one cycle of antibiotic drugs per year (mean 1.63+/-1.69 cycles of treatment per child per year). Of all therapeutic decisions, 85.2% were considered appropriate. In 36% of the processes antibiotics were prescribed (1,386 cycles), 46% of which were considered inappropriate either because no antibiotic therapy should have been given (71.6%) or because the chosen drug was not appropriate for the pathology (28.4%). There were significant differences among the evaluated physicians. The most correct decisions were taken by the pediatrician in the outpatient clinic, especially when compared with physicians in the emergency ward (p<0.0001). The most frequently prescribed antibiotic drugs were amoxicillin (41.2%) and amoxicillin combined with clavulanic acid (33%). Cephalosporin accounted only for 6.9% of the prescriptions. Antibiotic therapy is overprescribed in children, a situation that should be corrected.