Department of Pediatrics, Tampere University Hospital, and Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpönkatu 34 (ARVO B235), 33014, Tampere, Finland.
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Eur J Pediatr. 2022 Aug;181(8):2981-2990. doi: 10.1007/s00431-022-04512-w. Epub 2022 May 23.
Upper respiratory tract infection (URTI) is a self-limiting viral infection and should not be treated with antibiotics. The aim was to evaluate antibiotic prescriptions for children with uncomplicated URTI in a large nationwide private clinic network between 2014 and 2020. Special focus was given to macrolide prescriptions and costs. The data were obtained from the electronic health records (EHR) of the largest private healthcare company in Finland (with about 250,000 paediatric visits annually across the country). The collected variables included diagnoses, age, visit year, speciality of the doctor, and prescribed antibiotics. The number of uncomplicated URTIs in < 18-year-old children was 156,187 (53.0% in boys). The prescription rate of antibiotics decreased from 18.0% in 2014 to 8.8% in 2020, and that of macrolides from 6.1 to 1.7%. The costs decreased accordingly. Paediatricians prescribed antibiotics less often than general practitioners or ear, nose, and throat specialists.
Antibiotic prescriptions for uncomplicated URTIs, especially macrolides, decreased substantially during the 7-year surveillance period; however, 8.8% of children still received unnecessary antibiotics. To further reduce unwarranted antibiotic prescriptions, active interventions are needed that can be performed by applying the available EHR system.
• Upper respiratory tract infection (URTI) is the most common infection in children. Uncomplicated URTI is a self-limiting viral infection, and antibiotic treatment is not warranted.
• Almost 9% of children with uncomplicated URTIs still received unnecessary antibiotics. Paediatricians prescribed antibiotics less often than general practitioners or ear, nose, and throat specialists. To further reduce unwarranted antibiotic prescriptions, active interventions are needed that can be performed by applying the available EHR system.
上呼吸道感染（URTI）是一种自限性病毒感染，不应使用抗生素治疗。本研究旨在评估 2014 年至 2020 年间在一个大型全国性私人诊所网络中，对无并发症 URTI 儿童开具抗生素的情况。特别关注大环内酯类抗生素的处方和费用。该数据来自芬兰最大的私人医疗保健公司的电子健康记录（EHR）（该国每年约有 25 万儿科就诊）。收集的变量包括诊断、年龄、就诊年份、医生的专业以及开的抗生素。＜18 岁儿童中单纯性 URTI 的数量为 156187 例（男孩占 53.0%）。抗生素的处方率从 2014 年的 18.0%下降到 2020 年的 8.8%，大环内酯类抗生素的处方率从 6.1%下降到 1.7%。相应地，费用也降低了。与全科医生或耳鼻喉科专家相比，儿科医生开具抗生素的频率较低。
在 7 年监测期间，单纯性 URTI 抗生素处方，尤其是大环内酯类抗生素处方大量减少；然而，仍有 8.8%的儿童接受了不必要的抗生素治疗。为了进一步减少不必要的抗生素处方，需要采取积极的干预措施，可通过应用现有的 EHR 系统来实现。
•上呼吸道感染（URTI）是儿童最常见的感染。单纯性 URTI 是一种自限性病毒感染，不需要抗生素治疗。
•近 9%的单纯性 URTI 儿童仍接受不必要的抗生素治疗。儿科医生开具抗生素的频率低于全科医生或耳鼻喉科专家。为了进一步减少不必要的抗生素处方，需要采取积极的干预措施，可通过应用现有的 EHR 系统来实现。
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