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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Antibiotic Prescription Practices of Pediatricians and Pediatric Residents in Hospital Care in Greece

Author(s): Mary Geitona, Aikaterini Toska, Kyriakos Souliotis, Maria Saridi and Costas Demetzos

Volume 10, Issue 3, 2015

Page: [221 - 226] Pages: 6

DOI: 10.2174/1574886310666150602150619

Price: $65

Abstract

Introduction: The administration of antibiotics for the treatment of pediatric illnesses is common, reaching one third of pediatric patients. This paper aims to identify the antibiotic prescription practices of pediatricians and to explore the associations between prescribing practices and a series of socio-demographic and professional determinants in Greece.

Material and Method: A cross-sectional study was conducted in public hospitals providing secondary and tertiary pediatric care from January to July 2012. A self-administered questionnaire was developed and tested in a pilot study, focusing on respondents’ characteristics, their practices and attitudes related to prescribing antibiotics in common childhood diseases, diagnostic uncertainty, and parental demand. Multivariate regression analysis was performed.

Results: In total, 275 physicians responded to the questionnaire (61% response rate). The majority of the physicians prescribed antibiotics empirically in possible group A streptococcus infections (56.9%) and implemented the “watchful waiting” approach in acute otitis media (65.5%); further, they did not feel diagnostic uncertainty (74%) and were not affected by parental demand (81%). Finally, when prescribing, they did not take into consideration the drug cost (64.4%). Gender, physicians’ experience, and the type of hospital (specialized or general hospital) were identified as prognostic factors of prescribing practices.

Conclusion: Our findings could provide decision-makers with insights into how to manage physicians’ prescription practices in order to reduce the high rates of antibiotic consumption that Greece is facing nowadays.

Keywords: Antibiotics, children, Greece, hospital care, pediatricians, prescribing practices.

« Previous Next »
[1]
Zhang W, Shen X, Bergman U, et al. Drug utilization 90% (DU90%) profiles of antibiotics in five Chinese children’s hospitals (2002-2006). Int J Antimicrob Agents 2008; 32(3): 250-5.
[2]
Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis 2009; 48(1): 1-12.
[3]
Bharathiraya R, Sridharan S, Chelliah LR, Suresh S, Senguttuvan M. Factors affecting antibiotic prescribing pattern in pediatric practice. Ind J Pediatr 2005; 72(10): 877-9.
[4]
Pichichero ME. Understanding antibiotic overuse for respiratory tract infections in children. Pediatr 1999; 104: 1384-8.
[5]
Moro ML, Marchi M, Gagliotti C, Di Mario S, Resi D. Why do pediatricians prescribe antibiotics? Results of an Italian regional project. BMC Pediatr 2009; 9: 69.
[6]
Alumran A, Cameron H, Xiang-Yu H. Antibiotics overuse in children with upper respiratory tract infections in Saudi Arabia: risk factors and potential interventions. Clin Med Diagn 2011; 1: 8-16.
[7]
Pennie R. A prospective study on antibiotic prescribing for children. Can Fam Physician 1998; 44: 1850-6.
[8]
Bagshaw SM, Kellner JD. Beliefs and behaviors of parents regarding antibiotic use by children. Can J Infect Dis 2001; 12(2): 93-7.
[9]
Palinke N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu valley. Kathmandu Univ Med J 2004; 2(1): 6-12.
[10]
Viswanad V, Abraham S, Abraham A, Anupama PP, Muralidharan A, Subash AK. Confrontational Use Of Antibiotics In Pediatric Prescriptions. Deccan J Pharmaceutics Cosmetol 2010; 1(2): 52-6.
[11]
Amadeo BP, Muller A, Drapier N, et al. on behalf of the ESAC III Hospital Care Subproject Group European Surveillance of Antibiotic Consumption (ESAC) point prevalence survey 2008. Paediatric antimicrobial prescribing in 32 hospitals of 21 European countries. J Antimicrob Chemother 2010; 65: 2247-52.
[12]
Mc Caig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA 2002; 287: 3096-102.
[13]
Mc Caig LF, Besser RE, Hughes JM. Antimicrobial drug prescription in ambulatory care settings. United States, 1992-2000. Emerg infect dis 2003; 9(4): 432-7.
[14]
American Academy of Pediatrics. The diagnosis and management of acute otitis media. Pediatrics 2013; 131: 3.
[15]
Bisno A, Gerber M, Gwaltney J, Kaplan EL, Schwartz RH. for the Infectious Diseases Society of America. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis 2002; 35: 113-25.
[16]
Dowell S, Schwartz B, Phillips W. Appropriate use of antibiotics for URIs in children: Part II. Cough, pharyngitis and the common cold. The Pediatric URI Consensus Team. Am Fam Physician 1998; 58: 1335-42.
[17]
Guidelines for the Use of Antibiotics in Acute Upper Respiratory Tract Infections. Am Fam Physician 2006; 74(6): 956-66.
[18]
Gerber JS, Newland JG, Coffin SE, et al. Variability in antibiotic use at children’s hospitals. Pediatrics 2010; 126(6): 1067-73.
[19]
Hersh AL, Shapiro DJ, Pavia AT, Shah SS. Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics 2011; 128(6): 1053-61.
[20]
Vander Stichele RH, Elseviers MM, Ferech M, Blot S, Goossens H. European Surveillance of Antibiotic Consumption (ESAC) Project Group. Hospital consumption of antibiotics in 15 European countries: results of the ESAC Retrospective Data Collection (1997-2002). J Antimicrob Chemother 2006; 58(1): 159-67.
[21]
Gourgoulis GM, Katerelos P, Maragos A, Gargalianos P, Lazanas M, Maltezou HC. Antibiotic prescription and knowledge about antibiotic costs of physicians in primary health care centers in Greece. Am J Infect Control 2013; 41(12): 1296-7.
[22]
Paluck E, Katzenstein D, Frankish CJ, et al. Prescribing practices and attitudes toward giving children antibiotics. Can Fam Physician 2001; 47: 521-7.
[23]
Weissman J, Besser RE. Promoting appropriate antibiotic use for pediatric patients: a social ecological framework. Semin Pediatr Infect Dis 2004; 15(1): 41-51.
[24]
Stille CJ. Rifas- Shiman SL, Kleinman K, Kotch JB, Finkelstein JA. Physician responses to a community-level trial promoting judicious antibiotic use. Ann Fam Med 2008; 6(3): 206-12.
[25]
Toska A, Geitona M, Souliotis K, Saridi M, Demetzos C. Adverse drug reaction reporting related to the administration of antibiotics in hospitalized pediatric patients in Greece. Curr Drug Saf 2014; 9(1): 49-55.
[26]
Garcia C. LIamocca LP, Garcia K, et al. Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru. BMC Clin Pharmacol 2011; 15: 11-8.
[27]
Yagupsky P. Selection of antibiotic-resistant pathogens in the community. Pediatr Infect Dis J 2006; 25: 974-6.
[28]
Gervaix A, Egger M, Lacroix L, Harbarth S. Pediatricians’ perception of antibiotic use in children in two large Swiss cities. Int J Antimicrob Agents 2007; 30(3): 281-3.
[29]
Reichert S, Simon T, Halm EA. Physicians’ attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med 2000; 160(18): 2799-803.
[30]
Geitona M, Zavras D, Hatzikou M, Kyriopoulos J. Generics market in Greece: the pharmaceutical industry’s beliefs. Health Policy 2006; 79(1): 35-48.
[31]
Mangione-Smith R, Elliott MN, Stivers T, McDonald LL, Heritage J. Ruling out the need for antibiotics: are we sending the right message? Arch Pediatr Adolesc Med 2006; 160(9): 945-52.
[32]
Panagakou S, Spyridis N, Papaevangelou V, et al. Antibiotic use for upper respiratory tract infections in children: A cross sectional survey of knowledge, attitudes and practices of parents in Greece. BMC Pediatrics 2011; 11: 60.
[33]
Bjorkman I, Berg J, Roing M, Erntell M, Lundborg CS. Perceptions among Swedish hospital physicians on prescribing of antibiotics and antibiotic resistance. BMJ Qual Saf 2010; 19: 1-5.

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