C Levy1, M Pereira2, R Guedj3, C Abt-Nord4, N Baudino Gelbert4, R Cohen1, C Alberti5, V Gajdos6, F Angoulvant7. 1. Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 94000 Créteil, France. 2. Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France. 3. Service des urgences pédiatriques, université Pierre-et-Marie-Curie, hôpital Armand-Trousseau, AP-HP, 75012 Paris, France. 4. Association française de pédiatrie ambulatoire (AFPA), 30400 Villeneuve-les-Avignons, France. 5. Unité d'épidémiologie clinique Inserm CIE 5, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 75019 Paris, France. 6. Service de pédiatrie, université Paris-Sud, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France. 7. Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France. Electronic address: francois.angoulvant@rdb.aphp.fr.
Abstract
OBJECTIVE: In 2011, new guidelines on antibiotic prescription for acute otitis media (AOM) were published in France to decrease the use of third generation cephalosporins that promote the carriage of extended-spectrum beta-lactamase producing Escherichia coli. Our objective was to assess the impact of the 2011 French recommendations on the type of antibiotics prescribed for AOM. METHODS: Fourteen thousand six hundred and sixty-one children, 6 to 24 months of age, presenting with AOM were included in 2 studies, between November 1, 2009 and October 31, 2012. The first one was conducted with the support of 62 private practice pediatricians; the second one was conducted in 7 pediatric emergency departments. Three periods of 1 year each were defined. RESULTS: Antibiotics were prescribed in 12,471 (85.1%) of cases of AOM during the study period. Amoxicillin prescriptions was multiplied by 25, between the first year (2.6%) and the last year (66.1%). Conversely, prescriptions of cefpodoxime proxetil and amoxicillin-clavulanic acid decreased from 33.6% and 62.0% in the first year to 5.2% and 27.7% in the last year, respectively. This trend was observed in both private practices and in the pediatric emergency departments. CONCLUSION: Amoxicillin became the most frequently prescribed antibiotic for AOM in 2012, complying with the 2011 French guidelines, while the proportion of prescribed broad-spectrum antibiotics decreased. Our study highlights the importance of guidelines to decrease the prescription of broad-spectrum antibiotics, a crucial factor in the prevention of antibiotic resistance.
OBJECTIVE: In 2011, new guidelines on antibiotic prescription for acute otitis media (AOM) were published in France to decrease the use of third generation cephalosporins that promote the carriage of extended-spectrum beta-lactamase producing Escherichia coli. Our objective was to assess the impact of the 2011 French recommendations on the type of antibiotics prescribed for AOM. METHODS: Fourteen thousand six hundred and sixty-one children, 6 to 24 months of age, presenting with AOM were included in 2 studies, between November 1, 2009 and October 31, 2012. The first one was conducted with the support of 62 private practice pediatricians; the second one was conducted in 7 pediatric emergency departments. Three periods of 1 year each were defined. RESULTS: Antibiotics were prescribed in 12,471 (85.1%) of cases of AOM during the study period. Amoxicillin prescriptions was multiplied by 25, between the first year (2.6%) and the last year (66.1%). Conversely, prescriptions of cefpodoxime proxetil and amoxicillin-clavulanic acid decreased from 33.6% and 62.0% in the first year to 5.2% and 27.7% in the last year, respectively. This trend was observed in both private practices and in the pediatric emergency departments. CONCLUSION:Amoxicillin became the most frequently prescribed antibiotic for AOM in 2012, complying with the 2011 French guidelines, while the proportion of prescribed broad-spectrum antibiotics decreased. Our study highlights the importance of guidelines to decrease the prescription of broad-spectrum antibiotics, a crucial factor in the prevention of antibiotic resistance.
Authors: Yelin Deniz; Rick T van Uum; Marieke L A de Hoog; Anne G M Schilder; Roger A M J Damoiseaux; Roderick P Venekamp Journal: Arch Dis Child Date: 2018-03-03 Impact factor: 3.791