title: [Therapeutic conduct in children attended in emergency room during the epidemic of influenza A H1N1].
abstract: OBJECTIVE
  To analyze the prescription of antiviral and antibiotic agents in children with upper airway infection (UAI) during Influenza H1N1 epidemic.
  
  
  METHODS
  A cross-section study (01/04/2009 to 31/03/2010) was performed. We analyzed the antiviral and antibiotic agents' prescription and its relation with the presence of the triad of symptom of suspicion (migraine, fever and cough) and the cost for attention (medicines and screening test).
  
  
  RESULTS
  838 children were attendance for UAI, 40.3% with the suspicion triad. In 733 patients, the screening test were done with 155 positive results (120 had the triad). All patient with a positive result received oseltamivir. During the first five months of the epidemic, the medical prescriptions were: antibiotics 60-85%, 0-7% anti-viral and 20-30% symptomatic drugs. At the 6th at 8th months (peak of outbreak) antibiotics 35-70%, antivirals 20-25% and 10-30% symptomatic drugs. At final months (9th to 11th) antimicrobials 65-80%, antivirals 20-30% and symptomatic 0-10%. The cost for URI attention increased a 27%.
  
  
  CONCLUSIONS
  Medical prescription changed during the epidemic, with an increased in the antivirals, especially for patients with high suspicion for influenza and positive screening test.
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. mario.rendon@imss.gob.mx
authors.forename: Mario Enrique
authors.initials: ME
authors.lastname: Rendón-Macías
authors.forename: Fabiola Alejandra
authors.initials: FA
authors.lastname: Hernández-Romano
authors.forename: José
authors.initials: J
authors.lastname: Iglesias-Leboreiro
authors.forename: Isabel
authors.initials: I
authors.lastname: Bernardez-Zapata
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004638:Emergency Treatment; D058872:Epidemics; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008800:Mexico / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents