title: A challenge to appropriate antibiotic use in children with respiratory infections: a 5-year single-institution experience.
abstract: BACKGROUND
  We have studied the rate of emergence of antibiotic-resistant Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) and the subsequent antibiotic use in host patients of those isolates at the Department of Pediatrics, Soma General Hospital, Fukushima. Moreover, we carried out several studies investigating the risks and benefits of antibiotic-free treatment for children with respiratory infections. In this report, we summarize our research and suggest better treatment options for pediatric patients with respiratory infections.
  
  
  METHODS
  We investigated the necessity of antibiotic use in the treatment of pediatric inpatients with respiratory syncytial virus (RSV) infection, and tested our hypothesis that antibiotic-free treatment for common cold will reduce the number of resistant S. pneumoniae strains in the pediatric nasopharynx. Therefore, we restricted prescribing antibiotics for pediatric patients with respiratory infections. The rates of resistant S. pneumoniae and H. influenzae and the medication history of the host patients before and after the intervention were compared.
  
  
  RESULTS
  We found that most of the RSV-infected patients recovered without antibiotic treatment, and that the antibiotic-free treatment inhibited the emergence of antibiotic-resistant strains. The rate of penicillin-resistant S. pneumoniae decreased but the rate of ampicillin-resistant H. influenzae did not change significantly during the study.
  
  
  CONCLUSIONS
  We concluded that patients with respiratory infections can be treated without antibiotics, under careful examination and observation. Continued monitoring of such new interventions as well as recommending their use to other caregivers and physicians will help inhibit the spread of resistant strains.
authors.affiliation: Department of Pediatrics, Fukushima Medical University, Fukushima, Japan. b-walk@fmu.ac.jp
authors.forename: Ayumi
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003139:Common Cold / Q000188:drug therapy; D004352:Drug Resistance, Microbial; D006192:Haemophilus Infections; D006193:Haemophilus influenzae; D006801:Humans; D057970:Inappropriate Prescribing; D011008:Pneumococcal Infections / Q000188:drug therapy; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents