Antibiotic Prescribing for Children with Upper Respiratory Tract Infection: a Finnish Nationwide 7-year Observational Study

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2022 May 23

PMID 35606593

Authors

Matti Korppi

Paula Heikkila

Sauli Palmu

Heini Huhtala

Peter Csonka

Affiliations

Soon will be listed here.

Abstract

Conclusion: Antibiotic prescriptions for uncomplicated URTIs, especially macrolides, decreased substantially during the 7-year surveillance period; however, 8.8% of children still received unnecessary antibiotics. To further reduce unwarranted antibiotic prescriptions, active interventions are needed that can be performed by applying the available EHR system.

What Is Known: • Upper respiratory tract infection (URTI) is the most common infection in children. Uncomplicated URTI is a self-limiting viral infection, and antibiotic treatment is not warranted.

What Is New: • Almost 9% of children with uncomplicated URTIs still received unnecessary antibiotics. Paediatricians prescribed antibiotics less often than general practitioners or ear, nose, and throat specialists. To further reduce unwarranted antibiotic prescriptions, active interventions are needed that can be performed by applying the available EHR system.

Citing Articles

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References

Armengol C, Hendley J, Winther B . Occurrence of acute otitis media during colds in children younger than four years. Pediatr Infect Dis J. 2011; 30(6):518-20. DOI: 10.1097/INF.0b013e3182044930. View

Juven T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M . Etiology of community-acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J. 2000; 19(4):293-8. DOI: 10.1097/00006454-200004000-00006. View

Jain S, Williams D, Arnold S, Ampofo K, Bramley A, Reed C . Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015; 372(9):835-45. PMC: 4697461. DOI: 10.1056/NEJMoa1405870. View

Senstad A, Suren P, Brauteset L, Eriksson J, Hoiby E, Wathne K . Community-acquired pneumonia (CAP) in children in Oslo, Norway. Acta Paediatr. 2008; 98(2):332-6. DOI: 10.1111/j.1651-2227.2008.01088.x. View

Tan T, Little P, Stokes T . Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance. BMJ. 2008; 337:a437. DOI: 10.1136/bmj.a437. View

Stordal K, Wyder C, Trobisch A, Grossman Z, Hadjipanayis A . Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP). Eur J Pediatr. 2019; 178(12):1923-1927. DOI: 10.1007/s00431-019-03461-1. View

Isba R, Edge R, Auerbach M, Cicero M, Jenner R, Setzer E . COVID-19: Transatlantic Declines in Pediatric Emergency Admissions. Pediatr Emerg Care. 2020; 36(11):551-553. PMC: 7493767. DOI: 10.1097/PEC.0000000000002260. View

Kuitunen I, Artama M, Makela L, Backman K, Heiskanen-Kosma T, Renko M . Effect of Social Distancing Due to the COVID-19 Pandemic on the Incidence of Viral Respiratory Tract Infections in Children in Finland During Early 2020. Pediatr Infect Dis J. 2020; 39(12):e423-e427. DOI: 10.1097/INF.0000000000002845. View

Trinh N, Cohen R, Lemaitre M, Chahwakilian P, Coulthard G, Bruckner T . Community antibiotic prescribing for children in France from 2015 to 2017: a cross-sectional national study. J Antimicrob Chemother. 2020; 75(8):2344-2352. DOI: 10.1093/jac/dkaa162. View

10.

Lin L, Harbarth S, Hargreaves J, Zhou X, Li L . Large-scale survey of parental antibiotic use for paediatric upper respiratory tract infections in China: implications for stewardship programmes and national policy. Int J Antimicrob Agents. 2021; 57(4):106302. DOI: 10.1016/j.ijantimicag.2021.106302. View

11.

Frost H, McLean H, Chow B . Variability in Antibiotic Prescribing for Upper Respiratory Illnesses by Provider Specialty. J Pediatr. 2018; 203:76-85.e8. DOI: 10.1016/j.jpeds.2018.07.044. View

12.

Schwartz K, Langford B, Daneman N, Chen B, Brown K, McIsaac W . Unnecessary antibiotic prescribing in a Canadian primary care setting: a descriptive analysis using routinely collected electronic medical record data. CMAJ Open. 2020; 8(2):E360-E369. PMC: 7207032. DOI: 10.9778/cmajo.20190175. View

13.

Tapiainen T, Aittoniemi J, Immonen J, Jylkka H, Meinander T, Nuolivirta K . Finnish guidelines for the treatment of laryngitis, wheezing bronchitis and bronchiolitis in children. Acta Paediatr. 2015; 105(1):44-9. DOI: 10.1111/apa.13162. View

14.

Tapiainen T, Aittoniemi J, Immonen J, Jylkka H, Meinander T, Nuolivirta K . Finnish guidelines for the treatment of community-acquired pneumonia and pertussis in children. Acta Paediatr. 2015; 105(1):39-43. DOI: 10.1111/apa.13177. View

15.

Csonka P, Heikkila P, Koskela S, Palmu S, Lajunen N, Riihijarvi S . Cough and cold medicine prescription rates can be significantly reduced by active intervention. Eur J Pediatr. 2021; 181(4):1531-1539. PMC: 8673918. DOI: 10.1007/s00431-021-04344-0. View

16.

Korppi M, Heikkila P, Palmu S, Huhtala H, Csonka P . Antibiotic prescriptions for children with lower respiratory tract infections fell from 2014 to 2020, but misuse was still an issue. Acta Paediatr. 2022; 111(6):1230-1237. DOI: 10.1111/apa.16323. View

17.

Korppi M . Restrictions for COVID-19 prevented other respiratory infections and reduced emergency visits in children. Acta Paediatr. 2022; 111(8):1479-1480. PMC: 9347402. DOI: 10.1111/apa.16408. View

18.

Dekker A, van der Velden A, Luijken J, Verheij T, van Giessen A . Cost-effectiveness analysis of a GP- and parent-directed intervention to reduce antibiotic prescribing for children with respiratory tract infections in primary care. J Antimicrob Chemother. 2019; 74(4):1137-1142. DOI: 10.1093/jac/dky552. View