Medica Jadertina, Vol. 45 No. 1-2, 2015.
Stručni rad
Antibiotic prescription for acute respiratory infections in preschool children in family medicine
Marina Bašek
orcid.org/0000-0002-6659-4089
; Medicinski fakultet Sveučilišta u Zagrebu (studentica 6. godine Studija medicine)
Stanislava Stojanović-Špehar
; Škola narodnoga zdravlja "Andrija Štampar", Katedra obiteljske medicine, Medicinski fakultet Sveučilišta u Zagrebu i Specijalistička ordinacija obiteljske medicine
Maša Davidović
; Dom zdravlja Zagreb Zapad, Zagreb
Sažetak
Leading diseases in preschool children in Croatia are diseases of the respiratory system (about 35%), as well as the leading reason for unjustified antibiotics prescription.
Objective: To investigate the burden of family medicine practices during the winter months due to RTI in preschool children and to assess the prescription of antibiotics in relation to socioeconomic factors, health status and health habits of children and characteristics of the consultation.
Patients and methods: The prospective study was conducted in three family medicine practices in Zagreb during three winter months from 1st December 2013 – 28th February 2014. The sample included 265 preschool children. Data were collected from the e - medical records in a questionnaire compiled for this study.
Results: 105 (39.6 %) children during the winter months visited their general practitioners for about 146 RTI episodes. In 25.7% of these episodes an antibiotic was issued. Prescription of antibiotics was significantly higher in children: with older parents (pmum = 0.002, pdad = 0.05), with chronic diseases (p = 0.03 ), frequent attendees (p < 0.001). 21/28 antibiotics were prescribed on the first visit. Most antibiotics were prescribed on Monday and often to the children who came later that day and older children between 5-6 years. The antibiotics were often prescribed to children with higher CRP values (p = 0.017) and leukocytes (p = 0.043). The most common diagnoses for the prescribed antibiotics were: in 9/28 cases acute otitis media (H65), 8/28 acute tonsillitis (J03), and 4 cases of acute sinusitis (J01) and acute bronchitis (J20). Penicillin was the most prescribed antibiotic (21/28). Logistic regression analyses also predicted a correlation between antibiotic prescriptions and families with many children, children who attend nursery, and children with higher parental perception of child vulnerability.
Conclusion: The results of our study about the frequency of antibiotic prescription to preschool children for RTI correspond to investigations conducted in countries with low antibiotic prescription rate. Better education of doctors and the development of guidelines which would help them in the decision-making process in terms of antibiotics prescription may even reduce the rate of prescription as well as sensitize the public.
Ključne riječi
preschool children; family medicine; antibiotics; RTI
Hrčak ID:
143629
URI
Datum izdavanja:
17.8.2015.
Posjeta: 1.677 *