Overprescribing of antibiotics to children in rural Vietnam.
100 children (aged 1-6 y), who received an antibiotic prescription after health examination in the Bavi health care system (79 children at a district hospital, 21 at a community health centre) were analysed regarding antibiotics prescribed in relation to serum C-reactive protein (CRP). A control group consisted of 35 healthy children. Children who had been treated with antibiotics within 1 week prior to the study were excluded in the community health centre and control groups. Capillary blood samples were collected and the serum CRP concentration was analysed. A questionnaire interview with the carers was performed. Elevated CRP concentrations (>10 mg/l) were detected in 17 (17%) of the study population, and only 2 had a CRP level above 25 mg/l, one 36 mg/l and the other 140 mg/l. In the control group, none of the children had elevated CRP. The most common diagnoses were acute respiratory tract infection (ARI, 55%), asthma (7%), tonsillitis (4%), and diarrhoea (4%). The average number of drugs per patient was 3.1, and 77% received vitamins and 15% corticosteroids in combination with antibiotics. A majority of children who received an antibiotic prescription based on clinical examination did not have an elevated CRP and overprescribing of antibiotics was thus indicated.
Larsson
Mattias
M
Department of Public Health Sciences, Division of International Health (IHCAR), The Karolinska Institute, SE-171 76, Stockholm, Sweden.
Falkenberg
Torkel
T
Dardashti
Alain
A
Ekman
Tomi
T
Törnquist
Sam
S
Kim Chuc
Nguyen Thi
NT
Hansson
Lars-Olof
LO
Kronvall
Göran
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D004363:Drug Utilization; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D012424:Rural Population; D014744:Vietnam
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein