[Office-based pediatricians' knowledge and adherence to a consensus statement on acute rhinopharyngitis in the child].
OBJECTIVE
To assess the impact on community-based pediatricians of the conclusions of the 10th Conférence de Consensus en Thérapeutique Anti-Infectieuse (CCTAI) on the antibiotic treatment in acute nasopharyngitis (ANP).


METHODS
Fifty-six pediatricians took part in the study. Over a period of 15 days in October 1998, all the children (n = 997) presenting an ANP were prospectively included. The prescription of an antibiotic treatment as well as the clinical criteria authorizing it, according to the conclusions of the 10th CCTAI, were recorded. The participants were not told the purpose of the study.


RESULTS
Sixty percent of the pediatricians questioned were familiar with the 10th CCTAI. Forty-five percent said they complied with it, but only 7% stated it had changed their day-to-day clinical practice. Based on the conclusions of the 10th CCTAI, an antibiotic treatment would have been discussed for 38% of the children. Twenty-four percent of them were given one. For 54% of the children that were given an antibiotic, such treatment was disapproved by the 10th CCTAI. No significant association has been established between familiarity with the 10th CCTAI and the following criteria: gender, age, hospital activity, years of practice, medical journals read, and belief in the existence of a license for one or more antibiotics for ANP in children. However, this last criterion was significantly (P = 0.03) associated with an increase in the percentage of antibiotics prescribed: 29% vs 16%.


CONCLUSIONS
The 10th CCTAI has had a moderate impact on the day-to-day practice of the pediatricians who took part in our study. Several explanations are discussed. The authors emphasize the virtual lack of indications of antibiotics in ANP.
Chalumeau
M
M
Inserm U149, unité de recherches épidémiologiques sur la santé des femmes et des enfants, Paris, France.
Salanave
B
B
Assathiany
R
R
Kemeny
J
J
Breart
G
G
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003139:Common Cold / Q000188:drug therapy*; D003245:Consensus Statements as Topic; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010372:Pediatrics; D010612:Pharyngitis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents
Connaissance et application par des pédiatres de ville de la conférence de consensus sur les rhinopharyngites aiguës de l'enfant. Groupe AREPEGE.