title: Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions.
abstract: Children with acute respiratory or ear infections (RTI/OM) are often unnecessarily prescribed antibiotics. Antibiotic resistance is a major public health problem and antibiotic prescription for RTI/OM should be reduced. Anthroposophic treatment of RTI/OM includes anthroposophic medications, nonmedication therapy and if necessary also antibiotics. This secondary analysis from an observational study comprised 529 children <18 years from Europe (AT, DE, NL, and UK) or USA, whose caregivers had chosen to consult physicians offering anthroposophic (A-) or conventional (C-) treatment for RTI/OM. During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 25.6% of C-patients (P < 0.001); unadjusted odds ratio for nonprescription in A- versus C-patients 6.58 (95%-CI 3.45-12.56); after adjustment for demographics and morbidity 6.33 (3.17-12.64). Antibiotic prescription rates in recent observational studies with similar patients in similar settings, ranged from 31.0% to 84.1%. Compared to C-patients, A-patients also had much lower use of analgesics, somewhat quicker symptom resolution, and higher caregiver satisfaction. Adverse drug reactions were infrequent (2.3% in both groups) and not serious. Limitation was that results apply to children of caregivers who consult A-physicians. One cannot infer to what extent antibiotics might be avoided in children who usually receive C-treatment, if they were offered A-treatment.
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, University of Witten-Herdecke, Zechenweg 6, 79111 Freiburg, Germany.
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hamre
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, University of Witten-Herdecke, Zechenweg 6, 79111 Freiburg, Germany.
authors.forename: Anja
authors.identifier: 0000-0003-2257-3507
authors.initials: A
authors.lastname: Glockmann
authors.affiliation: Paediatric Practice, Quellengasse 42, 8010 Graz, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schwarz
authors.affiliation: Integrative Medicine Institute, Overton Street, Portland, OR 97210, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Riley
authors.affiliation: University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, The Netherlands ; Louis Bolk Instituut, Hoofdstraat 24, 3972 LA Driebergen-Rijsenburg, The Netherlands.
authors.forename: Erik W
authors.initials: EW
authors.lastname: Baars
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, University of Witten-Herdecke, Zechenweg 6, 79111 Freiburg, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Kiene
authors.affiliation: Institute for Applied Epistemology and Medical Methodology, University of Witten-Herdecke, Zechenweg 6, 79111 Freiburg, Germany.
authors.forename: Gunver S
authors.initials: GS
authors.lastname: Kienle