IMPACT OF FRENCH ANTIBIOTIC GUIDELINE FOR ACUTE RESPIRATORY TRACT INFECTIONS IN A PEDIATRIC EMERGENCY DEPARTMENT, 2005-2009.
ESPID Education. Angoulvant F. Jun 7, 2011; 7702 Disclosure(s): none
Francois Angoulvant
Francois Angoulvant

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Abstract
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Context: Antibiotic overuse contributes to the emergence and the dissemination of multi-drug resistant bacteria. Acute respiratory tract infections (ARTI) are the main reason for antibiotic prescription in children. In 2005, the French medicine agency published guidelines to reduce the misuse of antibiotics for ARTI.
Methods: To determine the impact of the implementation of guidelines to reduce antibiotic prescriptions for ARTI in a pediatric emergency department (PED), we performed a retrospective analysis of prospectively collected data in a French PED from November 2005 (date of guideline implementation) to October 2009. For every child diagnosed with an ARTI, the following data were collected: date of visit, age, diagnosis, and antibiotic prescription. These data were used to calculate the proportion of antibiotic prescriptions for ARTI at discharge during and after the implementation of the French guidelines.
Results: During the study period, 60,165 children were diagnosed with ARTI in our PED; 60% of the 22,198 antibiotic prescriptions given at discharge were related to ARTI. The proportion of antibiotic prescription in ARTI visits fell from 29.8% during the first year of implementation of French antibiotic guidelines to 19.9% at year 4 (p < 10-4, Cochran-Armitage test). The percentage of antibiotic prescription at discharge decreased for most types of ARTI, except for acute otitis media and pneumonia. Amoxicillin-clavulanic acid and amoxicillin were the two most prescribed antibiotics, accounting for 50% and 35% of antibiotic prescriptions for ARTI, respectively.
Conclusions: Antibiotic prescription rates for ARTI declined significantly in our PED with the implementation of French antibiotic guidelines.
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