A survey on prescription of antibiotics in respiratory tract infections
Reference of this article: Herranz Jordán B, Pérez Martín C. A survey on prescription of antibiotics in respiratory tract infections. Rev Pediatr Aten Primaria. 2005;7:557-578.
Published in Internet: 31-12-2005 - Visits: 9581
Background: Spain is one of the European countries with greatest antibiotic consumption,
and therefore, with greatest bacterial resistance. Most antibiotics are prescribed in primary
health care, mainly for the treatment of respiratory tract infections. There is little data
to assess if the prescriptions of antibiotics by primary care paediatricians for the treatment
of respiratory tract infections follow the current recommendations.
Objective: to evaluate the pattern of antibiotic prescription in respiratory tract infections
by primary care paediatricians in Madrid. Secondary objectives were to determine the source
of information on the use of antibiotics and the influence of parents on the prescription.
Method: an anonymous survey was designed with the following questions: 8 about the
physician and their job, 2 to evaluate the sources of information on antibiotics, 2 to evaluate
the influence of parents on the prescriptions and finally 35 questions to evaluate the treatment
of nine clinical cases of common respiratory tract infectious diseases (all cases provided
had open diagnosis). In a first phase, the printed survey was sent to 20% of primary
care paediatricians of Madrid, selected randomly. In a second phase the rest 80% were invited
in a personal letter by mail to complete the same survey trough intra or internet.
Results and conclusions: the survey was completed by 144 (19% of all the primary care
paediatricians of Madrid), 71 of 137 (52%) selected in the first part (printed survey) and 73 of
679 (11%) in the second round (electronic survey). The statistical analysis was descriptive.
The most important conclusions were: doctors prescribe antibiotics unnecessarily specially in
common cold with fever, bronchiolitis and bronchitis. There was a great disparity of criteria in
the treatment of a case of possible bacterial sinusitis and a case of probably streptococcal
pharyngitis. The global prescription of amoxicillin-clavulanic was excessive, whereas the prescription
of cephalosporins and macrolide antibiotics was low and adequate. The use of internet
to update knowledge in this area was very poor. The most trustable scientific information
were revisions and meta-analysis. 31% of paediatricians reported frequent pressure to prescribe
antibiotics by the patients? parents even against the paediatrician?s recommendations. The
response to printed survey was much higher than the electronic survey what questions the utility
of electronic surveys at present.
Keywords● Antibiotics ● Paediatrics ● Primary care ● Respiratory tract infection