Impact des recommandations sur la prescription en consultation de ville d’antibiotiques à l’enfant

Abstract

The emergence of antibiotics resistance as a major public health threat has led, in France as in other countries, to the establishment of "antibiotics plans" based in part on practice guidelines. The objectives of this study were to determine the structure (number, causes, distribution of compounds) of antibiotic prescriptions by infectious diseases pediatricians (belonging to a pediatric infectious diseases research group), to check their compliance with guidelines and compare their prescriptions to other French pediatricians and general practitioners (GPs). In a survey on acute otitis media (AOM), outpatient pediatricians reported prospectively from October2013to February2014all antibiotics prescribed and the reasons for these prescriptions. These results were compared with prescription data from a panel of other pediatricians and GPs in France (IMS Health panels). Between October2013and February2014, 27pediatricians from the Infectious Disease Pediatricians Group conducted 54,212visits, 10.7% of which resulted in antibiotic prescriptions, all diseases combined, compared to 12% for other pediatricians and 21% for GPs in the same period. AOM was the leading cause of prescriptions for infectious disease pediatricians and panel pediatricians, and GPs (respectively, 72.6%, 33%, and 25%). Amoxicillin was the most frequently prescribed antibiotic (respectively, 71.7%, 49.9%, and 28.2%). Cephalosporins were prescribed in 6.4% of cases by infectious disease pediatricians versus 19% for panel pediatricians and 19.9% for GPs. The prescriptions of infectious disease pediatricians are in accordance with the French guidelines. The differences with the IMS data justify the need for continuous medical training and recommendations to promote these guidelines.