Impact of an Antibiotic Stewardship Program on Antibiotic Prescription for Acute Respiratory Tract Infections in Children: A Prospective Before-After Study

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1166-1174 ◽  
Author(s):  
Nalinee Aoybamroong ◽  
Worawit Kantamalee ◽  
Kunlawat Thadanipon ◽  
Chonnamet Techasaensiri ◽  
Kumthorn Malathum ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Respiratory Tract Infections ◽  
Instant Messaging ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Acute Respiratory Tract Infection ◽  
Stewardship Program ◽  
Tract Infections ◽  
E Mail

We assessed the effectiveness of an antibiotic stewardship program (ASP) on antibiotic prescriptions for acute respiratory tract infection (ARTI) in a medical school. Our ASP included delivering an antibiotic use guideline via e-mail and LINE (an instant messaging app) to faculty staff, fellows, and residents, and posting of the guideline in examination rooms. Medical records of pediatric patients diagnosed with ARTI were reviewed to assess the appropriateness of antibiotic prescription. ASP could increase the rate of appropriateness from 78% (1979 out of 2553 visits) to 83.4% (2449 out of 2935 visits; P < .001). The baseline of appropriateness was higher in residents (95%) compared with fellows (82%) and faculty staff (75%). The ASP significantly increased the appropriateness only in faculty staff, especially in semiprivate clinics (75% to 83%, P < .001). In conclusion, our ASP increased appropriateness of antibiotic prescriptions for ARTI, with the greatest impact among faculty staff in semiprivate clinics.

scholarly journals Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship

2020 ◽  
Author(s):  
Xingrong Shen ◽  
Jilu Shen ◽  
Yaping Pan ◽  
Jing Cheng ◽  
Jing Chai ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Clinical Symptoms ◽  
Rural China ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Presenting Symptoms ◽  
Tract Infections

Abstract Background: This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural China and implications for future antibiotic stewardship.Methods: The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.Results: A total of 1068 completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR=1.91), season (OR=0.41 to 0.60), days since infection onset (OR=1.54 to 1.81), and runny or blocked nose (OR=1.39 to 1.61), cough with green or white sputum (OR=1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR=0.53) and sore throat (OR=1.64).Conclusions: The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.

scholarly journals Clinical symptoms and treatment of common respiratory tract infections in relation to microbiological profiles in rural health facilities in China: implications for antibiotic stewardship

2020 ◽  
Author(s):  
Xingrong Shen ◽  
Jilu Shen ◽  
Yaping Pan ◽  
Jing Cheng ◽  
Jing Chai ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Rural China ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Anhui Province ◽  
Presenting Symptoms ◽  
Tract Infections

Abstract Background This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural Anhui Province and implications for future antibiotic stewardship. Methods The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews in village clinics and township health centers were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing. Results A total of 1068 (51.0% males and 49.0% females) completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR = 1.91), season (OR = 0.41 to 0.60), days since infection onset (OR = 1.54 to 1.81), and runny or blocked nose (OR = 1.39 to 1.61), cough with green or white sputum (OR = 1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR = 0.53) and sore throat (OR = 1.64). Conclusions The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by patient reassurance and other non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.

scholarly journals Competition in primary care and prescription of antibiotics in Norway

2020 ◽  
Author(s):  
Yana Zykova
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Average Length ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Potential Link ◽  
Tract Infections ◽  
Resistance Rates ◽  
And Control

Appropriate use of antibiotics is an important strategy to combat the problem of growing antibiotic resistance rates. In order to follow this strategy, it is important to understand the determinants of antibiotic use. We analyse the potential link between competition among general practitioners (GPs) measured with the Herfindahl-Hirshman index (HHI) and regional antibiotic consumption in Norway in 2015 and 2016. We use the data about antibiotic consumption expressed by the number of prescriptions of antibiotics for systemic use (J01) and by the number of antibiotics for respiratory tract infections (phenoxymethylpenicillin (J01CE02), doxycycline (J01AA02), amoxicillin (J01CA04) and macrolides (J01FA)) per 1000 inhabitants. We apply multiple regression analysis to the data mentioned above and control for socioeconomic characteristics of the municipalities. Our findings suggest that competition may contribute to about 37-80 additional antibiotic prescriptions per 1000 inhabitants per year and 23-46 additional prescriptions per 1000 inhabitants of antibiotics for respiratory tract infections. Moreover, our estimations suggest that antibiotic prescription is significantly related to the average number of consultations per patient, the average length of the patient list, travel time to a pharmacy, income, and the share of women.

scholarly journals Clinical Symptoms and Treatment of Common Respiratory Tract Infections in Relation to Microbiological Profiles in Rural Health Facilities in China: Implications for Antibiotic Stewardship

2020 ◽  
Author(s):  
Xingrong Shen ◽  
Jilu Shen ◽  
Yaping Pan ◽  
Jing Cheng ◽  
Jing Chai ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Clinical Symptoms ◽  
Rural China ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Presenting Symptoms ◽  
Tract Infections

Abstract Background This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural China and implications for future antibiotic stewardship.Methods The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.Results A total of 1068 completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR=1.91), season (OR=0.41 to 0.60), days since infection onset (OR=1.54 to 1.81), and runny or blocked nose (OR=1.39 to 1.61), cough with green or white sputum (OR=1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR=0.53) and sore throat (OR=1.64).Conclusions The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

The effect of probiotics on prevention of upper respiratory tract infections in the paediatric community – a systematic review

2020 ◽  
Vol 11 (3) ◽  
pp. 201-211
Author(s):  
İ.E. Emre ◽  
Y. Eroğlu ◽  
A. Kara ◽  
E.C. Dinleyici ◽  
M. Özen
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Data Extraction ◽  
Antibiotic Use ◽  
Paediatric Population ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Randomised Controlled ◽  
Tract Infections

Prevention of acute upper respiratory tract infections (URTIs) is becoming an increasingly important concept in public health application due to the increase in antibiotic resistance. Probiotics have been shown to have some effect on prevention in various reviews. In this study we aimed to re-asses the effect of probiotics as there has been a substantial increase in literature regarding the effects and safety of probiotics in the paediatric population. Two major databases were systematically searched to identify clinical trials eligible for inclusion. Study selection, data extraction and quality assessment were carried out by two reviewers. This review comprises 33 randomised controlled trials (RCTs) applied to a paediatric population with high-quality methodology. The primary outcome for this review was the incidence of respiratory tract infections. Secondary outcomes were severity of symptoms, missed days of school, incidence of antibiotic use and safety of prebiotic use. This review showed that probiotics have an impact on decreasing the incidence of URTIs and the severity of symptoms. The use of probiotics is extremely safe and as studies increase in evaluation of the effect of probiotics more and more show a significant beneficiary effect. Although still a long way from becoming a unanimous treatment modality, the small positive changes that probiotics have on URTIs is important to consider and the use of probiotics should be encouraged more.

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