title: Are children carrying the burden of broad-spectrum antibiotics in general practice? Prescription pattern for paediatric outpatients with respiratory tract infections in Norway.
abstract: OBJECTIVE
  To investigate the antibiotic prescription pattern and factors that influence the physicians' choice of antibiotic.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Primary healthcare in Norway, December 2004 through November 2005.
  
  
  METHODS
  426 general practitioners, GPs, in Norway, giving 24 888 respiratory tract infection episodes with 19 938 children aged 0-6 years.
  
  
  METHODS
  Assess antibiotic prescription details and patient and GP characteristics associated with broad-spectrum and narrow-spectrum antibiotic use.
  
  
  RESULTS
  Of the 24 888 episodes in the study, 26.2% (95% CI 25.7% to 26.8%) included an antibiotic prescription. Penicillin V accounted for 42% and macrolide antibiotics for 30%. The prescription rate varied among the physicians, with a mean of 25.5% (95% CI 24.2% to 26.7%). Acute tonsillitis gave the highest odds for a prescription, OR 33.6 (95% CI 25.7% to 43.9%), compared to 'acute respiratory tract infections and symptoms' as a reference group. GPs with a prescription rate of 33.3% or higher had the larger probability for broad-spectrum antibiotic prescriptions, OR 3.33 (95% CI 2.01% to 5.54%). Antibiotic prescriptions increased with increasing patient age.
  
  
  CONCLUSIONS
  We found a low antibiotic prescription rate for childhood respiratory tract infections. However, our figures indicate an overuse of macrolide antibiotics and penicillins with extended spectrum, more so than in the corresponding study including the adult population. Palatability of antibiotic suspensions and other administrative challenges affect medication compliance in children. To help combat antibiotic resistance, guidelines need to be followed, in particular for our youngest patients.   TRIAL REGISTRATION NUMBER (CLINICALTRIALS.ORG):  NCT00272155.
authors.affiliation: Department of General Practice,  Institute of Health and Society, University of Oslo, Oslo,  Norway.
authors.forename: Guro Haugen
authors.initials: GH
authors.lastname: Fossum
authors.forename: Morten
authors.initials: M
authors.lastname: Lindbæk
authors.forename: Svein
authors.initials: S
authors.lastname: Gjelstad
authors.forename: Ingvild
authors.initials: I
authors.lastname: Dalen
authors.forename: Kari J
authors.initials: KJ
authors.lastname: Kværner