Background: Childhood infections are common in general practice. Although clinical guidelines recommend restrictive antibiotic use for children, antibiotics are too often prescribed. Objective: The aim of this study was to obtain insight in antibiotic prescribing for children related to clinical diagnoses. This is pivotal to define improvement strategies in the antibiotic management. Methods: In this observational study, we used consultation data collected from 45 general practices in the Netherlands in 2012. Infectious disease episode incidences, the number of antibiotic prescriptions per 1000 person-years, the proportion of episodes with an antibiotic prescription and the choice of antibiotic subclass were analysed for the most relevant diagnoses over different ages. Results: A total of 262 antibiotic courses were prescribed per 1000 person-years on average, with the highest number among children of 1 year (714/1000 person-years). Antibiotics were prescribed in 24% of infectious disease episodes. Acute upper respiratory tract infection (RTI) was the most common reason to visit the GP (173/1000 person-years), and the second most frequent indication to prescribe antibiotics. Antibiotics were most often prescribed for acute otitis media (58/1000 person-years). Amoxicillin dominated prescribing (55%), followed by macrolides (14%) and amoxicillin/clavulanate (10%), prescribing of narrow-spectrum antibiotics was low (10%). Conclusion: This detailed insight in antibiotic management of childhood infections shows targets for Dutch improvement strategies: (i) prevent antibiotic prescribing for acute upper RTI and bronchitis; (ii) stimulate the use of narrow-spectrum antibiotics; and (iii) reduce the use of macrolides and amoxicillin/clavulanate. Furthermore, this information is helpful to compare antibiotic policy between countries.
Background: Childhood infections are common in general practice. Although clinical guidelines recommend restrictive antibiotic use for children, antibiotics are too often prescribed. Objective: The aim of this study was to obtain insight in antibiotic prescribing for children related to clinical diagnoses. This is pivotal to define improvement strategies in the antibiotic management. Methods: In this observational study, we used consultation data collected from 45 general practices in the Netherlands in 2012. Infectious disease episode incidences, the number of antibiotic prescriptions per 1000 person-years, the proportion of episodes with an antibiotic prescription and the choice of antibiotic subclass were analysed for the most relevant diagnoses over different ages. Results: A total of 262 antibiotic courses were prescribed per 1000 person-years on average, with the highest number among children of 1 year (714/1000 person-years). Antibiotics were prescribed in 24% of infectious disease episodes. Acute upper respiratory tract infection (RTI) was the most common reason to visit the GP (173/1000 person-years), and the second most frequent indication to prescribe antibiotics. Antibiotics were most often prescribed for acute otitis media (58/1000 person-years). Amoxicillin dominated prescribing (55%), followed by macrolides (14%) and amoxicillin/clavulanate (10%), prescribing of narrow-spectrum antibiotics was low (10%). Conclusion: This detailed insight in antibiotic management of childhood infections shows targets for Dutch improvement strategies: (i) prevent antibiotic prescribing for acute upper RTI and bronchitis; (ii) stimulate the use of narrow-spectrum antibiotics; and (iii) reduce the use of macrolides and amoxicillin/clavulanate. Furthermore, this information is helpful to compare antibiotic policy between countries.
Authors: Annemarijn C Prins-van Ginkel; Alet H Wijga; Patricia C J Bruijning-Verhagen; Bert Brunekreef; Ulrike Gehring; Wim van der Hoek; Gerard H Koppelman; Lenie van Rossem; Marianne A B van der Sande; Henriëtte A Smit Journal: Int J Obes (Lond) Date: 2021-03-26 Impact factor: 5.095
Authors: Rune Aabenhus; Malene Plejdrup Hansen; Laura Trolle Saust; Lars Bjerrum Journal: NPJ Prim Care Respir Med Date: 2017-05-19 Impact factor: 2.871
Authors: Alexander C Ewing; Nicole L Davis; Dumbani Kayira; Mina C Hosseinipour; Charles van der Horst; Denise J Jamieson; Athena P Kourtis Journal: Emerg Infect Dis Date: 2019-01 Impact factor: 6.883
Authors: M J C Schot; A R J Dekker; C H van Werkhoven; A W van der Velden; J W L Cals; B D L Broekhuizen; R M Hopstaken; N J de Wit; T J M Verheij Journal: Fam Pract Date: 2019-11-18 Impact factor: 2.267
Authors: Marjolein J C Schot; Anne R J Dekker; Wesley G Giorgi; Rogier M Hopstaken; Niek J de Wit; Theo J M Verheij; Jochen W L Cals Journal: NPJ Prim Care Respir Med Date: 2018-10-26 Impact factor: 2.871