Abstract
Background and Objectives: Primary care physicians frequently prescribe antibiotics for acutely ill children, even though they usually have self-limiting diseases of viral etiology. The aim of this research was to evaluate the routine antibiotic-prescribing habits of primary care in Latvia, in response to children presenting with infections. Materials and Methods: This cross-sectional study included acutely ill children who consulted eighty family physicians (FP) in Latvia, between November 2019 and May 2020. The data regarding patient demographics, diagnoses treated with antibiotics, the choice of antibiotics and the use of diagnostic tests were collected. Results: The study population comprised 2383 patients aged between one month and 17 years, presenting an acute infection episode, who had a face-to-face consultation with an FP. Overall, 29.2% of these patients received an antibiotic prescription. The diagnoses most often treated with antibiotics were otitis (45.8% of all antibiotic prescriptions), acute bronchitis (25.0%) and the common cold (14.8%). The most commonly prescribed antibiotics were amoxicillin (55.9% of prescriptions), amoxicillin/clavulanate (18.1%) and clarithromycin (11.8%). Diagnostic tests were carried out for 59.6% of children presenting with acute infections and preceded 66.4% of antibiotic prescriptions. Conclusion: Our data revealed that a high level of antibiotic prescribing for self-limiting viral infections in children continues to occur. The underuse of narrow-spectrum antibiotics and suboptimal use of diagnostic tests before treatment decision-making were also identified. To achieve a more rational use of antibiotics in primary care for children with a fever, professionals and parents need to be better educated on this subject, and diagnostic tests should be used more extensively, including the implementation of daily point-of-care testing.
Highlights
Acute illness in pediatric patients is a common reason for seeking the help of family physicians (FP)
In order to evaluate the management of infectious diseases and the routine prescribing of antibiotics for children in primary care in Latvia, 80 FP from various Latvian regions were asked to record data on pediatric patients, aged from 1 month to 17 years, with an acute infection episode, who attended consultations during face-to-face appointments
These diagnoses were the ones most often treated with antibiotics; otitis was responsible for 45.8% of all antibiotic prescriptions, acute bronchitis for 25.0%, and the common cold for 14.8%
Summary
Acute illness in pediatric patients is a common reason for seeking the help of family physicians (FP). In these circumstances, the children mostly have self-limiting viral infections that do not require specific treatment. A recent study has shown that broad-spectrum antibiotics are often prescribed as the first-choice therapy in Latvia, contributing to the growing resistance to antibiotics [6]. Primary care physicians frequently prescribe antibiotics for acutely ill children, even though they usually have self-limiting diseases of viral etiology. The data regarding patient demographics, diagnoses treated with antibiotics, the choice of antibiotics and the use of diagnostic tests were collected. To achieve a more rational use of antibiotics in primary care for children with a fever, professionals and parents need to be better educated on this subject, and diagnostic tests should be used more extensively, including the implementation of daily point-of-care testing
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