Practice Characteristics Associated with Antibiotic Use in Children with Respiratory Tract Infections

Abstract

Antibiotics are frequently prescribed for conditions that do not warrant their use, such as the common cold, purulent rhinitis and acute bronchitis. Viruses are a common cause of pneumonia, especially in infants and young children. Many other bacteria can also cause pneumonia, the most serious kind. Cross sectional Study conducted on infants and children from 2 months up to five years who presented to emergency department and outpatient clinic, of Children's Hospital, Ain Shams University, Cairo, Egypt. Three hundred patients with upper and lower respiratory tract infection were enrolled only cases. We aimed to evaluate Practice Characteristics Associated with Antibiotic Use in Children with Respiratory infections.

The study populations were shows (42.7%) males and (57.3%) 53% were above the age of one. Patients were explored for previous antibiotic prescription and duration from last encounter to study time varied between 4 -9 months.

Results of previous respiratory illness: Out of 300 patients the most common complaint was a fever in combination with other manifestation of respiratory tract infection. Out of the 300 patients, 130 patients (43.3%) received an antibiotic in previous respiratory illness. Antibiotics were prescribed previously more frequently among male patients. Antibiotics were prescribed more for pharyngitis; then in a descending manner for pneumonia, bronchitis and tonsillitis . Fifty five percent of mothers were told about the dose and duration of antibiotic prescribed, where as 49% only were told about the side effects. Only 42% of mothers completed antibiotic course as described by the physician. Results of current respiratory illness: Out of the 300 patients, 236 patients (78.8%) received an antibiotic in their current acute respiratory illness. Upper respiratory tract infection (56.4%) was diagnosed more frequently than Lower respiratory tract infection (43.6%). No effect of gender was observed on frequency distribution of antibiotic prescribtion for the current ARI There is significant difference regarding percentage of antibiotic prescription for different diagnoses of upper and lower respiratory infection. Amino-penicillins group of antibiotics was the most prescribed for upper respiratory tract infections. Macrolides and amikacine were the most prescribed for lower respiratory infections. Injection was the mainly first line of treatment in current study. Around two thirds of patients received antibiotics in appropriate dose for body weight. This study shows that fifty percent were told about dose and duration of antibiotic, 44.9% have had an idea about side effects of antibiotic, and 40.7% were appointed for reassessment. More than half of group under study, (56%) were assessed by juniors.The study shows significant higher antibiotic use in juniors (95.2% respectively) compared to seniors and sub seniors (57.4% and 70%). This study shows that 72% of caregivers were concerned about the importance of the antibiotics before being assessed for respiratory illness.