Background and importance Programs for optimising the use of antibiotics (PROA ) have been demonstrated to be useful tools to guarantee the rational use and adequacy of antibiotics, while decreasing the risk of developing treatment resistances.
Given the extensive use of antibiotics and, in order to expand the program, we decided to study the possibility of including the paediatric emergency care unit as part of the PROA.
Aim and objectives The main objectives of the study were:
To identify the need for a PROA in the paediatrics emergency care unit of a third-level hosptital by analysing the current situation.
To analyse the adequacy of the antibiotics prescribed (indication and duration) according to the local guide of the centre.
Material and methods A cross-sectional study in the Paediatrics Emergency Care Unit was used as pilot test. The day the study was completed, the relation of registered children in the unit was obtained via an informatic program. Both demographic (age and weight) and clinical (symptomatology, complementary tests, diagnosis and discharge treatment) were registered. For each patient, adequacy of the prescribed antibiotic, indication and dose adjustment to weight and age, were analysed.
Results From the 114 assessed patients, 16 (14%) were treated with antibiotics and recruited for follow-up. The most common diagnosis was tonsillitis (25%), acute bronchitis (19%) and otitis media (19%), being the remaining percentage cases of appendicitis, urinary tract infections, nasopharyngitis, cellulitis and laryngitis. From the 16 prescribed treatments, 12 were susceptible of recommendation.The main identified causes for treatment modification were an excessive duration (50%), an inadequate dose for either shortage (25%) or excess (8%) or a suboptimal antibiotic choice (17%).
Conclusion and relevance Results showed a low adequacy of the antibiotic treatments, thus evidencing the need for a PROA that improves the prescription quality and guarantees patient safety. Members from the PROA group must ensure education about antibiotics prescription, emphasising the features of children as a population group and sharing the local antibiotic guide from the hospital.
Conflict of interest No conflict of interest