title: Inappropriate antibiotic prescription to children with acute respiratory infection in Brazil.
abstract: OBJECTIVE
  To determine the rate of inappropriate antibiotic prescription and to describe the types of antibiotics prescribed by health workers to children with acute respiratory infection (ARI).
  
  
  METHODS
  Cross-sectional survey conducted in 6 state capitals of Brazil.
  
  
  METHODS
  A representative sample of facilities was selected in each state using a cluster sampling method based on the mean number of visits of children less than 5 years of age. In each facility, consultations were observed and children were reassessed following standard guidelines. Health worker s diagnosis and treatment were compared with a gold standard and inappropriate antibiotic prescriptions noted.
  
  
  RESULTS
  1565 children with ARI from 156 health facilities (73% health centers) were included in study. Most children had a common cold (77.5%). Antibiotics were inappropriately prescribed in 9.2% (95% CI: 7.8, 10.7) of ARI cases (range: 2.8% to 25%). Most frequently prescribed antibiotics were those recommended by the ARI Program. Seventy-six percent of health workers explained to guardians how to use antibiotics at home and 3.9% demonstrated the first dose. Antibiotics were available in 84% of health facilities.
  
  
  CONCLUSIONS
  Inappropriate prescription of antibiotics varied geographically in Brazil. More training and supervision is needed to decrease it.
authors.affiliation: Department of Pediatrics IPPMG - Universidade Federal do Rio de Janeiro, Brazil. acunha@ufrj.br
authors.forename: Antonio Jose Ledo Alves
authors.initials: AJ
authors.lastname: da Cunha
authors.forename: Joao
authors.initials: J
authors.lastname: Amaral
authors.forename: Maria Anice Fontenele
authors.initials: MA
authors.lastname: e Silva
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001938:Brazil; D002675:Child, Preschool; D016000:Cluster Analysis; D003139:Common Cold / Q000188:drug therapy; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D011014:Pneumonia / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents