Italian Primary Care Paediatrics Society (SICuPP), Lombardy, Italy.
Department of Health Science and Community Health, University of Milan, Milan, Italy.
Ital J Pediatr. 2023 Sep 29;49(1):131. doi: 10.1186/s13052-023-01533-5.
Antibiotic overuse in children is a significant public health concern, as it can lead to the emergence and spread of antibiotic-resistant bacteria. Although respiratory infections account for most antibiotic prescriptions in children, many of these infections are viral and do not require antibiotics. In this study, we aimed to investigate the use of antibiotics in children with respiratory infections in a primary care setting and to explore the possible role of fever on antibiotic prescription.
We conducted a prospective observational study that evaluated preschool children aged 0-5 years who were assessed by their primary care pediatricians for respiratory infectious diseases between October 2019 and March 2021. The study involved 69 public primary care pediatricians and a total of 678 pediatric episodes for respiratory infections.
Amoxicillin/clavulanate was the most frequently prescribed drug. Bronchitis accounted for most of inappropriate antibiotic prescriptions (73%). Furthermore, the presence of fever was associated with a ~ 300% increase in the likelihood of prescribing antibiotics for respiratory infections that do not typically require antibiotics.
Our findings emphasize the need for adherence to international guidelines and recommendations in the primary care of children to reduce unnecessary antibiotic use and prevent the development of antibiotic resistance. This study also underscores the potential relevance of new studies to evaluate antibiotic prescription attitudes in other clinical settings and geographical areas.
儿童抗生素滥用是一个重大的公共卫生问题，因为它会导致抗生素耐药菌的出现和传播。尽管呼吸道感染是儿童中大多数抗生素处方的原因，但其中许多感染是病毒引起的，不需要使用抗生素。在这项研究中，我们旨在调查初级保健环境中儿童呼吸道感染中抗生素的使用情况，并探讨发热对抗生素处方的可能作用。
我们进行了一项前瞻性观察研究，评估了 2019 年 10 月至 2021 年 3 月期间由初级保健儿科医生评估的 0-5 岁学龄前儿童的呼吸道传染病。该研究涉及 69 名公共初级保健儿科医生和总共 678 例呼吸道感染儿科病例。
阿莫西林/克拉维酸是最常开的药物。支气管炎占不合理抗生素处方的大多数（73%）。此外，发热的存在与不典型抗生素治疗呼吸道感染的可能性增加约 300%相关，而这些感染通常不需要使用抗生素。
我们的研究结果强调了在儿童初级保健中遵循国际指南和建议的必要性，以减少不必要的抗生素使用并预防抗生素耐药性的发展。本研究还强调了在其他临床环境和地理区域评估抗生素处方态度的新研究的潜在相关性。
