Background and importance In the paediatric population, a potentially high use of antibiotics has been verified. The inappropriate use of these drugs leads to a progressive increase in resistance rates, which is a major public health problem worldwide.
Aim and objectives The objective of the study was to analyse the rationale for antibiotic prescriptions in acute respiratory infections in the paediatric hospital area.
Material and methods A 1 year retrospective observational study was conducted (from November 2016 to October 2017) of episodes of hospital admission for acute respiratory infection in paediatric patients. An expert committee was set up to analyse the rationale for antimicrobial therapy, according to five criteria: indication, choice of drug, dosage, frequency of administration and duration of treatment.
Results 319 children were included in the study, aged (median, range) 2.3 years (1 month–14 years); 178 (55.8%) were male. 72% were diagnosed with acute bronchitis and the rest had community acquired pneumonia. Antibiotics were prescribed in 41% of bronchitis and 92% of pneumonia cases. 408 antibiotic prescriptions were evaluated, the most being broad spectrum antibiotics (27% azithromycin and 26% amoxicillin). 44.3% of patients had a correct antibiotic prescription. Rationality of antibiotic prescription was: 80.6% indication, 81.1% choice of drug, 76.2% dosage, 99.7% frequency of administration and 55.1% duration of treatment. The worst criterion was duration of treatment in patients with community acquired pneumonia, which was incorrect in 62.5% (75.8% for excess of days).
Conclusion and relevance The study data showed a wide margin of improvement in the hospital prescription of antibiotics in paediatric patients. The duration of treatment was the criterion with the least degree of adequacy, being incorrect in almost half of the prescriptions. There is a clear need for urgent action, such as implementing optimisation programmes for the use of antimicrobials in paediatric services, to put a stop to the indiscriminate use of these drugs and improve clinical outcomes of patients with infections, minimise adverse effects associated with the use of antimicrobials as well as microbial resistance, and guarantee the use of cost effective treatments.
Conflict of interest No conflict of interest
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