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Mas-Dalmau G, Pérez-Lacasta MJ, Alonso-Coello P, Gorrotxategi-Gorrotxategi P, Argüelles-Prendes E, Espinazo-Ramos O, Valls-Duran T, Gonzalo-Alonso ME, Cortés-Viana MP, Menéndez-Bada T, Vázquez-Fernández ME, Pérez-Hernández AI, Muñoz-Ortiz L, Villanueva-López C, Little P, de la Poza-Abad M, Carles-Lavila M. A trial-based cost-effectiveness analysis of antibiotic prescription strategies for non-complicated respiratory tract infections in children. BMC Pediatr 2023; 23:497. [PMID: 37784098 PMCID: PMC10544479 DOI: 10.1186/s12887-023-04235-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 08/07/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Antibiotic prescription for respiratory tract infections (RTIs) in children attending primary care centres is almost double that predicted according to bacterial prevalence. Delayed antibiotic prescription (DAP) is designed to deploy a more rational use of antibiotics. While studies have evaluated DAP efficacy and safety for children with RTIs, little research has been conducted on the economic implications. METHODS Our trial compared cost-effectiveness for DAP, immediate antibiotic prescription (IAP), and no antibiotic prescription (NAP) for children aged 2-14 years with acute uncomplicated RTIs attended to in 39 primary care centres in Spain. The main outcome was the incremental cost-effectiveness ratio (ICER), measured in euros per gained quality-adjusted life days (QALDs). Net monetary benefit (NMB) was also calculated as a tool for decision making. The analysis was performed from a societal perspective for a time horizon of 30 days, and included healthcare direct costs, non-healthcare direct and indirect costs, and the antimicrobial resistance (AMR) cost. RESULTS DAP was the most cost-effective strategy, even when the cost of AMR was included. QALD values for the three strategies were very similar. IAP compared to DAP was more costly (109.68 vs 100.90 euros) and similarly effective (27.88 vs 27.94 QALDs). DAP compared to NAP was more costly (100.90 vs 97.48 euros) and more effective (27.94 vs. 27.82 QALDs). The ICER for DAP compared to NAP was 28.84 euros per QALD. The deterministic sensitivity analysis indicated that non-healthcare indirect costs had the greatest impact on the ICER. The cost-effectiveness acceptability curve showed that DAP was the preferred option in approximately 81.75% of Monte Carlo iterations, assuming a willingness-to-pay value of 82.2 euros per gained QALD. CONCLUSIONS When clinicians are in doubt about whether an antibiotic is needed for children with RTIs attending PC centres, those treated with the DAP strategy will have slightly better efficiency outcomes than those treated with IAP because its costs are lower than those of IAP. DAP is also the most cost-effective strategy over a time horizon of 30 days if AMR is considered, despite higher short-term costs than NAP. However, if in the long term the costs of AMR are larger than estimated, NAP could also be an alternative strategy. TRIAL REGISTRATION This trial has been registered at www. CLINICALTRIALS gov (identifier NCT01800747; Date: 28/02/2013 (retrospectively registered).
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Affiliation(s)
- Gemma Mas-Dalmau
- Department of Epidemiology and Public Health - Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Nursing Care Research Group, IIB Sant Pau, Barcelona, Spain
| | - María José Pérez-Lacasta
- Department of Economics, Universitat Rovira i Virgili, Reus, Spain
- Economic Challenges for the Next Generation (ECO-NEXT: SGR2021-00729), Reus, Spain
- Research Centre On Economics and Sustainability (ECO-SOS), Reus, Spain
| | - Pablo Alonso-Coello
- Department of Epidemiology and Public Health - Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | | | | | | | | | - María Encarnación Gonzalo-Alonso
- Ugao Miraballes Primary Care Centre, Ugao Miraballes, Spain
- Arrigorriaga Primary Care Centre, Arrigorriaga, Spain
- Ariz-Basauri Primary Care Centre, Basauri, Spain
| | | | | | | | | | - Laura Muñoz-Ortiz
- Catalan Agency for Health Quality and Assessment (AQuAS), Barcelona, Spain
| | | | - Paul Little
- Aldermoor Primary Care Centre, Southampton, UK
| | | | - Misericòrdia Carles-Lavila
- Department of Economics, Universitat Rovira i Virgili, Reus, Spain.
- Economic Challenges for the Next Generation (ECO-NEXT: SGR2021-00729), Reus, Spain.
- Research Centre On Economics and Sustainability (ECO-SOS), Reus, Spain.
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Kostev K, van den Boom L, Tanislav C, Jacob L. Changes in the Prescription of Antibiotics and Phytopharmaceuticals in Children Treated for Acute Upper and Lower Respiratory Tract Infections in Pediatric Practices in Germany in 2013, 2018, and 2022. Antibiotics (Basel) 2023; 12:1491. [PMID: 37887192 PMCID: PMC10604680 DOI: 10.3390/antibiotics12101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Background: Little is known about the recent trends in antibiotic and phytopharmaceutical prescribing for acute upper (URIs) and lower respiratory tract infections (LRIs) in children and adolescents. Therefore, this study investigated changes in the prescription of antibiotics and phytopharmaceuticals in children diagnosed with acute URIs and LRIs in pediatric practices in Germany in 2013, 2018, and 2022. Methods: The present retrospective study included children aged 2-12 years diagnosed with acute URIs or LRIs in one of 180 pediatric practices in 2013, 2018, and 2022. The URIs included nasopharyngitis, sinusitis, pharyngitis, tonsillitis, laryngitis and tracheitis, and upper respiratory infections of multiple and unspecified sites, while the LRIs corresponded to bronchitis. The primary outcomes were the proportion of children being prescribed antibiotics and the proportion of those being prescribed phytopharmaceuticals. Results: A total of 120,894 children were diagnosed with acute URIs or LRIs in 2013 compared to 116,844 in 2018 and 127,821 in 2022. The prevalence of antibiotic prescription decreased for all diagnoses between 2013 and 2022. This decrease was statistically significant for both 2013-2018 and 2018-2022 for nasopharyngitis, pharyngitis, and bronchitis. Meanwhile, there was a significant increase in the use of phytopharmaceuticals for all diagnoses between 2013 and 2018. The prevalence of phytopharmaceutical prescription decreased slightly between 2018 and 2022, but this decrease was generally not statistically significant. Conclusions: The prescription of antibiotics has decreased and that of phytopharmaceuticals has increased in children diagnosed with acute URIs and LRIs in Germany over the last decade. More data are needed to corroborate these findings in other settings.
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Affiliation(s)
- Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt, Germany
- University Clinic, Philipps-Universität Marburg, 35043 Marburg, Germany
| | - Louisa van den Boom
- Division of Pediatrics/Pediatric Diabetology, DRK Hospital, 57548 Kirchen, Germany
- Division of Pediatric Diabetology, Endocrinology, Metabolism and Obesity, Children’s Hospital, University of Bonn, 53127 Bonn, Germany
| | - Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling, 57074 Siegen, Germany;
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain
- AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, 75010 Paris, France
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Antimicrobial Stewardship Programs (ASPS) in pediatric primary care. An Pediatr (Barc) 2023; 98:136.e1-136.e11. [PMID: 36774296 DOI: 10.1016/j.anpede.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/17/2022] [Indexed: 02/11/2023] Open
Abstract
Antibiotic resistance is a major threat to global health. Optimizing the use of antibiotics is a key measure to prevent and control this problem. Antimicrobial Stewardship Programs (ASPs) are designed to improve clinical outcomes, minimize adverse effects and protect patients, and to ensure the administration of cost-effective treatments. Inappropriate use of antibiotics also occurs in pediatric clinical practice. For this reason, ASPs should include specific objectives and strategies aimed at pediatricians and families. Implementing these programs requires the involvement of institutions and policy makers, healthcare providers as well as individuals, adapting them to the characteristics of each healthcare setting. Pediatric primary care (PPC) faces specific issues such as high demand and immediacy, scarce specialized professional resources, difficulties to access regular training and to obtain feedback. This requires the design of specific policies and strategies to achieve the objectives, including structural and organizational measures, improvement of the information flow and accessibility to frequent trainings. These programs should reach all health professionals, promoting regular trainings, prescription support tools and supplying diagnostic tests, with adequate coordination between health care levels. Periodic evaluations and surveillance tools are useful to assess the impact of the actions taken and to provide feedback to health providers in order to adapt and improve their clinical practice to meet ASPs objectives.
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Programas de optimización del uso de antibióticos (PROA) en pediatría de atención primaria. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Bonet-Esteve AM, Font-Ribera L, Dorca-Vila J, Retamal-Cañiz A, Roura-Poch P, Vidal-Alaball J. [Introduction of rapid streptococcal antigen test: can its use improve adherence to antibiotic therapy?]. Aten Primaria 2021; 53:102102. [PMID: 34507074 PMCID: PMC8433117 DOI: 10.1016/j.aprim.2021.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/12/2021] [Accepted: 04/06/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the influence of the result of a rapid streptococcal antigen test in paediatric pharyngotonsillitis infections, in terms of improvement of antibiotic therapy adherence. DESIGN Randomized community clinical trial with two study groups. LOCATION Primary Care Centers in Central Catalonia. PARTICIPANTS Patients aged from 3 to 15 years, who were attended at paediatric consultations on suspicion of pharyngotonsillitis caused by an infection between November 2010 and February 2011 (both included), were included in the study on a consecutive basis. 557 patients met the inclusion criteria and 519 were evaluated. INTERVENTION The control group received the usual diagnostic-therapeutic algorithm. Rapid streptococcal antigen test was additionally performed to experimental group participants and it was indicated the more convenient treatment. MAIN MEASUREMENTS Antibiotic adherence, non-adherence causes and socio-demographic risk factors were evaluated via telephone survey. RESULTS Antibiotics were prescribed to 65.6% and paediatricians of the control group were more likely to prescribe antibiotic than the ones in the intervention group (88.5% vs 45.5%, p< 0.0001). 64.8% followed doctor's treatment orders, being failure following medication scheduling the main cause of non-adherence (25.6%). Medication adherence was higher in the experimental group (68%) than in the control group (62.9%) but no significant differences were found. CONCLUSION Rapid strep test, complementing the use of Centor Criteria avoids unnecessary antibiotics prescriptions, but had not been proven to be effective in increasing medication adherence.
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Affiliation(s)
- Anna Maria Bonet-Esteve
- Unitat de Farmàcia Atenció Primària. Gerència Territorial Catalunya Central. Institut Català de la Salut, Sant Fruitós de Bages, España; Grupo de Investigación PROSAARU (Promoción de la Salud en el Ámbito Rural), Gerència Territorial Catalunya Central. Institut Català de la Salut, Sant Fruitós de Bages, España
| | | | - Judit Dorca-Vila
- Xarxa Assistencial Universitària de Manresa, Calle Dr. Joan Soler, 1-3, Manresa 08243, España
| | - Antonia Retamal-Cañiz
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, España
| | - Pere Roura-Poch
- Servei d'Atenció Primària d'Osona. Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, España
| | - Josep Vidal-Alaball
- Grupo de Investigación PROSAARU (Promoción de la Salud en el Ámbito Rural), Gerència Territorial Catalunya Central. Institut Català de la Salut, Sant Fruitós de Bages, España; Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, España; Facultat de Medicina. Universitat de Vic-Universitat Central de Catalunya, Vic, España.
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Evolution of antibiotic consumption in pediatric outpatients of Asturias, Spain (2005-2018). An Pediatr (Barc) 2021; 95:438-447. [PMID: 34785158 DOI: 10.1016/j.anpede.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/13/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Data about consumption of antibiotics in Spain are worrisome. They are mainly prescribed in the community sector and there is a high exposure to antibiotics in the pediatric population. The aim of this study is to describe the evolution of antibiotic consumption in the pediatric population of Asturias during 2005-2018 period. METHODS Retrospective and descriptive study using data about consumption of antibacterial agents for systemic use (J01 group of the Anatomical Therapeutic Chemical Classification) in pediatric outpatients in Asturias between 2005 and 2018. Data, expressed as defined daily dose (DDD) per 1000 inhabitants per day (DID), in three periods were compared. RESULTS Mean antibiotic consumption in pediatric outpatients in Asturias (2005-2018) was 14 DID (CI95% 13.4-14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). Remarkable data along the study were: 1) increase in amoxicillin consumption (p = 0.027), that have exceeded that of amoxicillin-clavulanate since 2011; 2) steady consumption of macrolides, with an increase in azithromycin (p < 0.001) and a decrease in clarithromycin (p = 0.001); 3) reduction of cephalosporins consumption (p < 0.001); 4) increase in quinolones consumption (p = 0.002). CONCLUSIONS Global antibiotic consumption in pediatric outpatients in Asturias between 2005 and 2018 has experienced a constant decrease lately and an improvement in patterns of antibacterial use.
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Calle-Miguel L, Iglesias Carbajo AI, Modroño Riaño G, Pérez Méndez C, García García E, Rodríguez Nebreda S, Solís Sánchez G. [Evolution of antibiotic consumption in pediatric outpatients of Asturias, Spain (2005-2018)]. An Pediatr (Barc) 2021; 95:S1695-4033(20)30496-3. [PMID: 33637470 DOI: 10.1016/j.anpedi.2020.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/08/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Data about consumption of antibiotics in Spain are worrisome. They are mainly prescribed in the community sector and there is a high exposure to antibiotics in the pediatric population. The aim of this study is to describe the evolution of antibiotic consumption in the pediatric population of Asturias during 2005-2018 period. MATERIAL AND METHODS Retrospective and descriptive study using data about consumption of antibacterial agents for systemic use (J01 group of the Anatomical Therapeutic Chemical Classification) in pediatric outpatients in Principado de Asturias between 2005 and 2018. Data, expressed as defined daily dose (DDD) per 1000 inhabitants per day (DID), in three periods were compared. RESULTS Mean antibiotic consumption in pediatric outpatients in Principado de Asturias (2005-2018) was 14 DID (CI95% 13.4-14.6). Consumption increased until 2009 (15.2 DID) and decreased from 2015 onwards (11.9 DID in 2018). Remarkable data along the study were: 1) increase in amoxicillin consumption (p=0.027), that have exceeded that of amoxicillin-clavulanate since 2011; 2) steady consumption of macrolides, with an increase in azithromycin (p<0.001) and a decrease in clarithromycin (p=0.001); 3) reduction of cephalosporins consumption (p<0.001); 4) increase in quinolones consumption (p=0.002). CONCLUSIONS Global antibiotic consumption in pediatric outpatients in Principado de Asturias between 2005 and 2018 has experienced a constant decrease lately and an improvement in patterns of antibacterial use.
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Affiliation(s)
- Laura Calle-Miguel
- Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
| | | | - Gracia Modroño Riaño
- Servicio de Farmacia Hospitalaria, Hospital de Cabueñes, Gijón, Asturias, España
| | | | - Elisa García García
- Pediatría de Atención Primaria, Centro de Salud Laviada, Gijón, Asturias, España
| | | | - Gonzalo Solís Sánchez
- Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
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Martin-Peinador Y, Albañil-Ballesteros MR, García-Vera C, Jimenez-Alés R, Muñoz-Hiraldo E, Martínez-Chamorro MJ. Access to complementary tests for the diagnosis of infectious diseases in primary care paediatric clinics. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Outpatient antibiotic use associated with acute upper respiratory infections in China: a nationwide cross-sectional study. Int J Antimicrob Agents 2020; 56:106193. [PMID: 33045344 DOI: 10.1016/j.ijantimicag.2020.106193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/14/2020] [Accepted: 09/26/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The assessment of antibiotic use for acute upper respiratory infections (AURIs) is important to promote the appropriateness of antibiotic prescribing. Evaluation of antibiotic prescriptions for AURIs at a national level is very limited in China. OBJECTIVE To investigate outpatient antibiotic prescriptions for AURIs in Chinese hospitals. METHODS This study used data from over 10 million outpatient and emergency department visits for AURIs, which contained information on drug prescription and diagnosis, from 94 cities and 28 provinces of mainland China. Antibiotic prescription rates for various subgroups and potential predictors of antibiotic use were estimated. Patterns of antibiotic prescriptions and proportions of individual antibiotics prescribed for different types of AURIs were analysed and reported. RESULTS In total, 10 770 219 outpatient visits for AURIs were included in this study. Of these, 40.8% (95% confidence interval 40.7-40.8%) resulted in antibiotic prescriptions. Patient characteristics, including age, gender, payment type, AURI type, department and season of visit, were significantly associated with antibiotic prescriptions for AURIs. In total, 4 984 744 antibiotic agents were prescribed, of which 87.9% were broad-spectrum antibiotics and only 36.8% were prescribed in line with the guideline recommendations. Azithromycin (13.2%), cefdinir (11.7%), cefixime (8.3%) and cefaclor (8.2%) were the most commonly prescribed antibiotics for AURIs in China. CONCLUSIONS Antibiotic prescribing for patients with AURIs in outpatient settings was prevalent nationwide in China. Antibiotic stewardship efforts targeting specific populations in outpatient settings are needed to reduce antibiotic use and promote appropriate antibiotic selection for AURIs in China.
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[Access to complementary tests for the diagnosis of infectious diseases in primary care paediatric clinics]. An Pediatr (Barc) 2020; 94:82-91. [PMID: 32430217 DOI: 10.1016/j.anpedi.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The performing of complementary tests in infectious processes can increase the diagnostic precision, the adequacy of treatments, as well as determining the epidemiology and pattern of bacterial resistance of the community. The Infectious Pathology Group of the Spanish Association of Primary Care Paediatrics (GPI-AEPap) has designed this study in order to determine the availability of complementary tests (CT) for paediatricians working in Primary Care of the public health system as well as their results. MATERIAL AND METHODS Observational cross-sectional descriptive national study was carried out using a voluntary self-report questionnaire distributed online to all AEPap members and to the subscribers of the PEDIAP distribution list between the months of April and May 2017. RESULTS A total of 517 responses were obtained. An analysis was made of the data from the professional environment, as well as those related to the request for basic supplementary tests (blood count, biochemistry, and routine urine analysis), the use of Rapid Antigen Detection Test for group A Streptococcus, bacterial cultures, serology, diagnostic tests for pertussis and tuberculosis (Mantoux), as well as imaging tests. CONCLUSIONS There is variability between Autonomous Communities and healthcare areas. Areas for improvement were found in the accessibility to different CT, collection time and sending of samples, delay in receiving results, as well as waiting times for non-urgent imaging tests. These affect the intervention and resolution capacity of the primary care paediatrician.
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Lincango EP, Barberis G, Saritama PA, Rojas GW. Caracterización del uso inapropiado de antibióticos en faringoamigdalitis según los criterios de McIsaac. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2019. [DOI: 10.5712/rbmfc14(41)2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: Describir el uso irracional de antibióticos en base a criterios de McIsaac (criterios de Centor modificados por McIsaac), en una unidad de salud de primer nivel de atención. Métodos: Se realizó un estudio descriptivo transversal con los registros de pacientes de 3 a 19 años atendidos en el servicio de emergencia (246), con los diagnósticos de faringitis aguda, amigdalitis aguda, e infecciones respiratorias superiores agudas de múltiples sitios y sin especificar. Se estableció como prescripción inadecuada si el facultativo indicó antibióticos con un puntaje menor o igual a 1 sobre 5 puntos o si no prescribió antibióticos con puntaje mayor o 4 sobre 5 puntos. Resultados: Se estimó 24,29% de uso inadecuado de antibióticos de los registros de emergencia. Se prescribió antibióticos en 160 pacientes, de los cuales se encontró que, amoxicilina fue el más utilizado (61,87%); seguido de benzilpenicilina benzatina (28,12%) y en tercer lugar macrólidos (8,12%). Conclusión: En la unidad de primer nivel analizada se encontró que el uso inadecuado de antibióticos es superior a la prevalecía estimada de faringoamigdalitis estreptocócica para el grupo de edad estudiado. Por esto, es imperativo que se tomen las medidas necesarias a nivel institucional y comunitario para lograr su reducción y evitar las complicaciones que se derivan de esta.
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García Vera C, Albañil Ballesteros MR. Antibiotics prescribing in paediatric primary care: A shared responsibility. An Pediatr (Barc) 2018. [DOI: 10.1016/j.anpede.2018.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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García Vera C, Albañil Ballesteros MR. [Antibiotics prescribing in paediatric primary care: A shared responsibility]. An Pediatr (Barc) 2018; 89:195-196. [PMID: 30054224 DOI: 10.1016/j.anpedi.2018.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- César García Vera
- Centro de Salud José Ramón Muñoz Fernández, Servicio Aragonés de Salud, Zaragoza, España; Grupo de Patología Infecciosa de la Asociación Española de Pediatría de Atención Primaria; Asociación Española de Pediatría de Atención Primaria en el grupo de trabajo del Plan Nacional frente a la Resistencia a los Antibióticos (PRAN).
| | - María Rosa Albañil Ballesteros
- Grupo de Patología Infecciosa de la Asociación Española de Pediatría de Atención Primaria; Asociación Española de Pediatría de Atención Primaria en el grupo de trabajo del Plan Nacional frente a la Resistencia a los Antibióticos (PRAN); Centro de Salud Cuzco, Servicio Madrileño de Salud, Madrid, España
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