title: Impact of implementing French antibiotic guidelines for acute respiratory-tract infections in a paediatric emergency department, 2005-2009.
abstract: Acute respiratory tract infections (ARTIs) are the main reason for antibiotic prescription in children. In 2005, the French Drug Agency published guidelines to minimise inappropriate use of antibiotics for ARTI. The purpose of this study was to assess the impact of implementing these guidelines in a paediatric emergency department. We retrospectively analysed data collected prospectively in a French paediatric emergency department from November 2005 (date of guideline implementation) to October 2009. For each child diagnosed with ARTI, we collected age, diagnosis, and prescribed antibiotics. We computed antibiotic prescription rates in the study population. During the study period, 53,055 children were diagnosed with ARTI and 59% of the 22,198 antibiotic prescriptions given at discharge were related to ARTI. The proportion of ARTI patients given antibiotic prescriptions fell from 32.1% during the first year to 21% in year 4 (p<10(-4), Cochran-Armitage test). Amoxicillin-clavulanic acid and amoxicillin accounted for 50% and 34% of antibiotic prescriptions for ARTI, respectively. French antibiotic guidelines led to significant decreases in antibiotic prescription for ARTI in our paediatric emergency department.
authors: Service d'Accueil des Urgences Pédiatriques, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris and Université Paris 7 Denis Diderot, 48 Boulevard Sérurier, 75019, Paris, France. francois.angoulvant@rdb.aphp.fr
authors: F
authors: F
authors: Angoulvant
authors: D
authors: D
authors: Skurnik
authors: H
authors: H
authors: Bellanger
authors: H
authors: H
authors: Abdoul
authors: X
authors: X
authors: Bellettre
authors: L
authors: L
authors: Morin
authors: M
authors: M
authors: Aptecar
authors: G
authors: G
authors: Galli-Gibertini
authors: O
authors: O
authors: Bourdon
authors: C
authors: C
authors: Doit
authors: A
authors: A
authors: Faye
authors: J-C
authors: JC
authors: Mercier
authors: R
authors: R
authors: Cohen
authors: C
authors: C
authors: Alberti
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004358:Drug Therapy / Q000592:standards*; D004632:Emergency Medical Services; D005260:Female; D005602:France; D006302:Health Services Research; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents