[The antibiotic treatment of respiratory infections in a pediatric emergency room].

Eight years after the first study published in this Journal (1985, 7: 533), we compared antibiotic treatment of respiratory infections at the Pediatric Emergency Department of the Children's Hospital in Trieste. All patients with pneumonia and pertussis received antibiotics, compared to 87% of otitis, 55% of pharyngo-tonsillitis, 4% of upper respiratory infections (U.R.I.); neither asthma nor laryngitis were treated with antibiotics. In particular, only 13% of otitis were treated by symptomatics, the others with amoxicillin (51%), amoxicillin + clavulanic acid (18%), cefaclor (12%), trimethoprim-sulphamethoxazole (5%), josamycin (1%). 45% of pharyngo-tonsillitis was treated with symptomatics, 32% with macrolides and 10% with penicillin; rarer treatment comprehended amoxicillin, amoxicillin + clavulanic acid (10%) and cefaclor (3%). Pneumonia was treated with amoxicillin or cefaclor (30% both), with amoxicillin + clavulanic acid (10%) or with macrolides (30%), the last in provision of mycoplasmal etiology. Antibiotic treatment of U.R.I. is progressively decreased from 79% in 1974 to 13% in 1983 and to 4% in 1991. Antibiotic treatment in our Department was appropriate in the majority of patients, with almost all bacterial form treated with first choice, cheaper antibiotic. A negative, limited trend was detected for pharyngo-tonsillitis: first choice antibiotics passed from 82% in 1983 to 76% in 1991. Another positive factor is due to the homogeneous manners of the doctors working at the Emergency Department, belonging to two different teams (Emergency and Clinical Departments), probably with the use of common clinical protocols.(ABSTRACT TRUNCATED AT 250 WORDS)