Rampant Use of Antibiotics for Respiratory Tract Illness

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Dear colleagues,

Rampant Use of Antibiotics for Respiratory Tract Illness in Children Continues

Despite warnings from public health officials about serious emerging antibiotic resistance, results from a study at a children's ED in Canada indicate that prescribing antibiotics for children with respiratory tract illness (RTI), likely to be viral in etiology, is still a prevalent practice.

ED records of febrile children diagnosed with upper respiratory illness, otitis media, pharyngitis, pneumonia, bronchiolitis, or reactive airway disease (RAD) were reviewed. Of 836 patients, 52% were diagnosed with viral illness or URI; 70% were younger than 2 years. Blood cultures were performed in 113 cases and none were positive. Fifty percent of patients who had positive nasopharyngeal aspirates for viruses either were already taking or were prescribed antibiotics in the ED. Overall, 45% of patients received antibiotics, many for conditions typically caused by viruses, including 66% with pharyngitis, 38% with bronchiolitis, 24% with RAD, and 14% with URI. For patients with URI, antibiotic prescription was associated with a fever lasting more than 48 hours (OR, 3.2; 95% CI, 1.7-5.9) and having a chest x-ray (OR, 2.1; 95% CI, 1.0-4.4). Patients with pharyngitis were less likely to receive antibiotics if they had a throat swab performed (OR, 0.08;

95% CI, 0.02-0.4).

Comment: Although this study was retrospective and no follow-up occurred, the results are convincing: EPs are part of the problem of widespread, unnecessary antibiotic use. To avoid this behavior, EPs should be encouraged to periodically review guidelines and recommendations on rational antibiotic use for respiratory tract illness in children.

— JM Baren

Published in Journal Watch Emergency Medicine February 1, 2000

Best Regards

Mohammad Bashaar

From: Vijay <drvijaythawani@ .co. in>Subject: Next discussion: RUM in respiratory infectionsnetrumgroups (DOT) comDate: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

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