Paediatricians Approach to Prescribing of Systemic Antimicrobials in Outpatient Children with Upper Respiratory Tract and ENT Infections: Data from Multicenter Survey | CMAC

Paediatricians Approach to Prescribing of Systemic Antimicrobials in Outpatient Children with Upper Respiratory Tract and ENT Infections: Data from Multicenter Survey

Clinical Microbiology and Antimicrobial Chemotherapy. 2016; 18(1):20-32

​ Rachina S.A., Kozlov R.S., Tatochenko V.K., PATRIOT study group
respiratory tract infections children antimicrobials pharmacoepidemiology
Section
Diseases and Pathogens
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2016; 18(1):20-32

Objective.

Objectives. The study aimed to assess paediatricians knowledge of etiology and approach to systemic antimicrobials (АМ) use in outpatient children with acute respiratory tract infections.

Materials and Methods.

A questionnaire survey of primary care paediatricians from 17 cities of Russian Federation was performed in 2011–2013 in compliance with the unified methodology.

Results.

A total of 701 paediatricians (mean age 46,3±10,7, 61,5% with work experience >15 years) took part in the survey. H. influenzae (26,4%), S. aureus (23,8%), S. pneumoniae (22,3%) were named among the most common pathogens of acute otitis media (AOM), while S. pyogenes (50,7%) и S. aureus (26,4%) — of acute bacterial tonsillopharyngitis (ABT). Altogether 71% of respondents reported otoscopy to be a part of diagnostic process in children with AOM. The vast majority of respondents declared they didn’t generally prescribe sAB for common cold, 89,3% of them experienced direct parents demand for AM use in children. High clinical efficacy (87,4%), possibility of oral administration (64,6%) and safety issues (62,6%) were the most commonly mentioned as the criteria of AM choice. In the vast majority of cases either penicillins (mainly amoxicillin/clavulanate) or macrolides (mainly azithromycin) were chosen for empiric therapy of outpatient children with AOM, ABT and acute rhinosinusitis. Post-graduate courses (81,3%), pharmaceutical sales representatives (80,3%), medical conferences (74,9%) were named among the main sources of information about AM by the respondents.

Conclusions.

Overestimated etiological role of S. aureus, possible negative influence of pharmaceutical companies and common parental demand for AM prescription in children in primary care are the main problems revealed. Inappropriatly high rate of inhibitor-protected penicillins choice in case of acute uncomlicated infections requires further educational actions.

Svetlana A. Rachina

Interregional Association for Clinical Microbiology & Antimicrobial Chemotherapy

Roman S. Kozlov

Interregional Association for Clinical Microbiology & Antimicrobial Chemotherapy
Smolensk State Medical University, Smolensk

Tatochenko V.K.

Scientific Center of Children’s Health, Moscow

PATRIOT study group

L. Zharkova, I. Zakharenkov (Smolensk State Medical University, Smolensk)
E. Dudnikova (Rostov-on-Don State Medical University, Rostov-on-Don)
I. Sakulina (Kaluga Region Administration, Ministry of Public Health, Kaluga)
S. Maltsev (Kazan State Medical Academy, Kazan)
Т. Spichak (I.M. Sechenov First Moscow State Medical University)
V. Seroklinov (Altay State Medical University, Barnaul)
О. Chirikova (Bryansk Region Administration, Department of Public Health, Bryansk)
N. Klimova (Amur Regional Children’s Hospital, Blagoveshchensk)
Т. Shumatova (Vladivostok State Medical University, Vladivostok)
G. Batischeva (Voronezh State Medical University, Voronezh)
S. Khokhlova (Yekaterinburg City Administration, Department of Public Health, Yekaterinburg)
L. Kryukova (Nizny Novgorod State Medical Academy, Nizny Novgorod)
F. Manerov (Novokuznetsk State Institute of Postgraduate Medicine, Novokuznetsk)
Т. Kaganova (Samara State Medical University, Samara)
Е. Pavlinova (Omsk State Medical Academy, Omsk)
I. Kosenko (Saint-Petersburg State Pediatric Medical University, Saint-Petersburg)
Е. Kondyurina (Novosibirsk State Medical University, Novosibirsk)

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