[Survey of the judicious use of antibiotics in primary care].
OBJECTIVE
To identify pediatricians' antibiotic prescribing habits in acute otitis media and tonsillopharyngitis and to determine the interaction between parents and pediatricians concerning antibiotic use in the Autonomous Community of Valencia (Spain).


METHODS
Four hundred members of the Valencian Society of Pediatrics were randomly selected. A semi-structured questionnaire with non-excluding answers was sent by mail and, when responses were not obtained, a second one was sent. The confidentiality of the information was guaranteed.


RESULTS
Of 400 questionnaires sent, 143 (35.8 %) were completed; 88.1 % were completed by pediatricians and 51.1 % by primary care workers. A total of 48.3 % of pediatricians used antibiotics in all cases of acute otitis media and 94.5 % prescribed them when fever and otalgia persisted for more than 48 hours. Amoxicillin-clavulanate was the most frequently prescribed antibiotic (63.6 %). Less than 10 % of pediatricians prescribed antibiotics as empirical treatment in tonsillopharyngitis; amoxicillin was the most frequently prescribed antibiotic (54.6 %). Indications for antibiotic treatment were fever, odynophagia and adenomegaly (69.5 %) and tonsillar exudate (62.5 %). Inappropriate antibiotic use was mainly due to excess workload. Providing health education to parents could be the best way of reducing inappropriate use.


CONCLUSIONS
Antibiotic use is frequent in the treatment of acute otitis media. Amoxicillin-clavulanate and amoxicillin were the most frequently prescribed antibiotics in tonsillopharyngitis. Providing health education to parents and reducing pediatricians' workload would decrease inappropriate antibiotic use.
Casaní Martínez
C
C
Centro de Salud de Segorbe y Soneja. Castellón. España. camarcar@alumni.uv.es
Calvo Rigual
F
F
Peris Vidal
A
A
Alvarez de Lavida Mulero
T
T
Díez Domingo
J
J
Graullera Millas
M
M
Ubeda Sansano
I
I
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004363:Drug Utilization / Q000592:standards; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy*; D010612:Pharyngitis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014069:Tonsillitis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents