title: Physicians' responsibility for antibiotic use in infants from periurban Lima, Peru.
abstract: OBJECTIVE
  To describe the use of antibiotics in Peruvian children under 1 year in a setting where they are available without a prescription.
  
  
  METHODS
  Data were analyzed from a cohort study between September 2006 and December 2007 of 1 023 children < 2 months old in periurban Lima, Peru, followed until they were 1 year old.
  
  
  RESULTS
  Seven hundred seventy of 1 023 (75.3%) children took 2 085 courses of antibiotics. There were two courses per child per year (range 0-12). Higher rates of antibiotic use were found in children 3-6 months old (37.2%). Antibiotics were given to children for 8.2% of common colds, 58.6% of all pharyngitis, 66.0% of bronchitis, 40.7% of diarrheas, 22.8% of dermatitis, and 12.0% of bronchial obstructions. A physician's prescription was the most common reason for antibiotic use (90.8%). Medication use without a prescription was found in 6.9% of children, and in 63.9% of them it was preceded by a physician's prescription.
  
  
  CONCLUSIONS
  Infants are often exposed to antibiotics in this setting. Overuse of antibiotics is common for diagnoses such as pharyngitis, bronchitis, bronchial obstruction, and diarrhea but is typically inappropriate (83.1% of courses) based on the most common etiologies for this age group. Interventions to improve the use of antibiotics should focus on physicians, since a physician's prescription was the most common reason for antibiotic use.
authors.affiliation: Instituto de Investigación Nutricional, Lima, Peru. lecker@iin.sld.pe
authors.forename: Lucie
authors.initials: L
authors.lastname: Ecker
authors.forename: Liset
authors.initials: L
authors.lastname: Olarte
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vilchez
authors.forename: Theresa J
authors.initials: TJ
authors.lastname: Ochoa
authors.forename: Isabel
authors.initials: I
authors.lastname: Amemiya
authors.forename: Ana I
authors.initials: AI
authors.lastname: Gil
authors.forename: Claudio F
authors.initials: CF
authors.lastname: Lanata
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001991:Bronchitis / Q000188:drug therapy / Q000453:epidemiology; D015331:Cohort Studies; D003139:Common Cold / Q000188:drug therapy / Q000453:epidemiology; D003872:Dermatitis / Q000188:drug therapy / Q000453:epidemiology; D003968:Diarrhea, Infantile / Q000188:drug therapy / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007223:Infant; D007229:Infant Welfare; D008297:Male; D010568:Peru / Q000453:epidemiology; D010612:Pharyngitis / Q000188:drug therapy / Q000453:epidemiology; D010819:Physician's Role; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012941:Social Responsibility; D018881:Suburban Health; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents