[Antimicrobial treatment of bronchial infections in hospital emergency rooms].
OBJECTIVE
To analyze antimicrobial prescribing habits in children diagnosed with bronchial infections in hospital emergency rooms.


METHODS
A descriptive study was performed in a random sample of children diagnosed with acute bronchitis and bronchiolitis in the emergency rooms of 11 Spanish hospitals. Information about the type of bronchial infection diagnosed and the antimicrobial treatment prescribed was gathered. The appropriateness of antibiotic prescriptions was assessed by comparing clinical practice in the use of antibiotics for bronchial infections with consensus guidelines developed for this study.


RESULTS
A total of 731 children were selected. The diagnosis was acute bronchitis in 531 (73 %) and bronchiolitis in 200 (27 %). Antimicrobial treatment was prescribed to 234 children (32 %; 95 % CI: 29-35 %). The most commonly prescribed antimicrobials were the aminopenicillins in 138 children (19 %; 95 % CI 16-22 %), cephalosporins in 54 (7 %; 95 % CI 5-9 %) and macrolides in 45 (6 % 95 % CI 4-8 %). The prescribed treatment was inappropriate in 26 % (95 % CI 23-29 %) of patients [31.5 % (95 % CI 27-35 %) of cases of acute bronchitis and 11.5 % (95 % CI 95 % 7-16 %) of cases of bronchiolitis]. Wide variability was observed in the inappropriate use of antimicrobial agents among the different hospitals, both in acute bronchitis (14-80 %) and in bronchiolitis (0-71 %).


CONCLUSIONS
Inappropriate antimicrobial treatment is prescribed to a considerable proportion of the children with bronchial infections attended in hospital emergency rooms, although there is wide variability among different hospitals. Programs to improve the quality of antimicrobial prescription should be developed. These should combine regulatory and educational measures directed at health professionals and the general public.
Fundació Institut Català de Farmacologia, Servicio de Farmacología Clínica, Hospital Universitario Vall d'Hebron, Barcelona, Spain. id@icf.uab.es
A
A
Vallano Ferraz
I
I
Danés Carreras
C
C
Ochoa Sangrador
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001988:Bronchiolitis / Q000188:drug therapy; D001991:Bronchitis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013030:Spain
D000900:Anti-Bacterial Agents