Ivanovska V, et al. - A comparative scrutiny was carried out of the physicians’ adherence to guidelines on antibiotic prescribing in fever and in the ear and respiratory infections to children in different age groups in the Netherlands. It was reported that more prescriptions were found in adolescents’ episodes than with children 0–4 and 5–11 years of age for diagnoses that generally did not require antibiotics. Findings revealed that high antibiotic rates for bronchitis, especially in adolescents, and underuse of narrow-spectrum penicillins in the 0–4 years group constituted the concerning adherence patterns.

Methods

• Data was cumulated from the NIVEL Primary Care Database.
• Experts analyzed if national guidelines were followed with regard to whether an antibiotic was prescribed, and the type of antibiotic for all pediatric episodes of fever, acute otitis media (AOM), streptococcal pharyngitis (strep throat), sinusitis, acute tonsillitis, acute bronchitis/bronchiolitis and pneumonia in 2012.

Results

• More prescriptions were revealed in adolescents’ episodes for diagnoses that generally did not require antibiotics, than with children 0-4 and 5-11 years of age, respectively, (bronchitis: 52.0% vs 42.4% and 42.7%, and fever: 16.8% vs 9.0% and 14.2%).
• This was also true for diagnoses that required antibiotics (strep throat: 76.5% vs 55.0% and 49.5%, pneumonia: 71.6% vs 60.2% and 69.8% and tonsillitis: 57.8% vs 54.8% and 49.7%), with the exception of AOM (43.9% vs 52.4% and 39.6%).
• The prescription of first-choice amoxicillin was noted more often in children 0-4 years of age when compared to age groups 5-11 and 11-17 years (AOM: 88.0% vs 83.2% and 81.8%, and pneumonia:74.7% vs 57.2% and 53.8%).
• Findings disclosed that in adolescents, first-choice narrow-spectrum penicillins were prescribed more frequently than in age groups 0-4 and 5-11 years (strep throat: 72.0% vs 63.6%, and 60.9% and tonsillitis: 67.9% vs 33.1 and 45.9%).