OBJECTIVES: Antibiotic misuse for viral upper respiratory tract infections (URI) in children is a significant problem. We determined the influence on antibiotic prescribing of clinical features that may increase concern about possible bacterial infection (age, appearance, fever) in children with URI. STUDY DESIGN: We created 16 scenarios of children with URI and distributed them by mail survey to 540 pediatricians and family practitioners in Ontario, Canada. The association of patient clinical features, parental pressure, and physician characteristics with antibiotic prescribing was determined through the use of logistic regression analysis. RESULTS: A total of 257 physicians responded (48%). Poor appearance (OR, 6.50; 95% CI, 5.06 to 3.84), fever above 38.5 degrees C (OR, 1.48; 95% CI, 1.21 to 1.82), and age older than 2 years (OR, 2.27; 95% CI, 1.85 to 2.78) were associated with prescribing, whereas parental pressure was not. Physician characteristics associated with antibiotic use were family practitioner (OR, 1.54; 95% CI, 1.22 to 1.96), increasing number of patients seen per week (OR, 1.05; 95% CI, 1.01 to 1.08 for every 20-patient increase), and increasing physician age (OR, 1.17; 95% CI, 1.11 to 1.24, 5-year increments). CONCLUSIONS: Clinical factors, which may lead physicians to be concerned about possible bacterial infection in children, are associated with antibiotic use for pediatric URI.
OBJECTIVES: Antibiotic misuse for viral upper respiratory tract infections (URI) in children is a significant problem. We determined the influence on antibiotic prescribing of clinical features that may increase concern about possible bacterial infection (age, appearance, fever) in children with URI. STUDY DESIGN: We created 16 scenarios of children with URI and distributed them by mail survey to 540 pediatricians and family practitioners in Ontario, Canada. The association of patient clinical features, parental pressure, and physician characteristics with antibiotic prescribing was determined through the use of logistic regression analysis. RESULTS: A total of 257 physicians responded (48%). Poor appearance (OR, 6.50; 95% CI, 5.06 to 3.84), fever above 38.5 degrees C (OR, 1.48; 95% CI, 1.21 to 1.82), and age older than 2 years (OR, 2.27; 95% CI, 1.85 to 2.78) were associated with prescribing, whereas parental pressure was not. Physician characteristics associated with antibiotic use were family practitioner (OR, 1.54; 95% CI, 1.22 to 1.96), increasing number of patients seen per week (OR, 1.05; 95% CI, 1.01 to 1.08 for every 20-patient increase), and increasing physician age (OR, 1.17; 95% CI, 1.11 to 1.24, 5-year increments). CONCLUSIONS: Clinical factors, which may lead physicians to be concerned about possible bacterial infection in children, are associated with antibiotic use for pediatric URI.
Authors: Anne J Blaschke; Daniel J Shapiro; Andrew T Pavia; Carrie L Byington; Krow Ampofo; Chris Stockmann; Adam L Hersh Journal: J Pediatric Infect Dis Soc Date: 2013-11-13 Impact factor: 3.164
Authors: Yoel Lubell; Nga T T Do; Kinh V Nguyen; Ngan T D Ta; Ninh T H Tran; Hung M Than; Long B Hoang; Poojan Shrestha; Rogier H van Doorn; Behzad Nadjm; Heiman F L Wertheim Journal: Antimicrob Resist Infect Control Date: 2018-10-04 Impact factor: 4.887
Authors: Sotiria G Panagakou; Vassiliki Papaevangelou; Adamos Chadjipanayis; George A Syrogiannopoulos; Maria Theodoridou; Christos S Hadjichristodoulou Journal: ISRN Pediatr Date: 2012-11-01
Authors: Lucas M Bachmann; Andrea Mühleisen; Annekatrin Bock; Gerben ter Riet; Ulrike Held; Alfons G H Kessels Journal: BMC Med Res Methodol Date: 2008-07-30 Impact factor: 4.615