[Impact of guidelines on ambulatory pediatric antibiotic prescriptions].
BACKGROUND
The emergence of antibiotics resistance as a major public health threat has led, in France as in other countries, to the establishment of "antibiotics plans" based in part on practice guidelines. The objectives of this study were to determine the structure (number, causes, distribution of compounds) of antibiotic prescriptions by infectious diseases pediatricians (belonging to a pediatric infectious diseases research group), to check their compliance with guidelines and compare their prescriptions to other French pediatricians and general practitioners (GPs).


METHODS
In a survey on acute otitis media (AOM), outpatient pediatricians reported prospectively from October 2013 to February 2014 all antibiotics prescribed and the reasons for these prescriptions. These results were compared with prescription data from a panel of other pediatricians and GPs in France (IMS Health panels).


RESULTS
Between October 2013 and February 2014, 27 pediatricians from the Infectious Disease Pediatricians Group conducted 54,212 visits, 10.7 % of which resulted in antibiotic prescriptions, all diseases combined, compared to 12 % for other pediatricians and 21 % for GPs in the same period. AOM was the leading cause of prescriptions for infectious disease pediatricians and panel pediatricians, and GPs (respectively, 72.6 %, 33 %, and 25 %). Amoxicillin was the most frequently prescribed antibiotic (respectively, 71.7 %, 49.9 %, and 28.2 %). Cephalosporins were prescribed in 6.4 % of cases by infectious disease pediatricians versus 19 % for panel pediatricians and 19.9 % for GPs.


CONCLUSIONS
The prescriptions of infectious disease pediatricians are in accordance with the French guidelines. The differences with the IMS data justify the need for continuous medical training and recommendations to promote these guidelines.
Service de néonatologie, hôpital Jean-Verdier, avenue du 14-juillet, 93140 Bondy, France. Electronic address: sellam.aurelie@gmail.com.
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Sellam
1, rue Boileau, 78000 Versailles, France.
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Chahwakilian
ACTIV, (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 St-Maur-des-Fossés, France; CRC, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France; AFPA, Association française de pédiatrie ambulatoire, 13 bis, place des Augustins, 33170 Gradignan, France; Unité court séjour, petits nourrisson, service de néonatologie, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
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Cohen
ACTIV, (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 St-Maur-des-Fossés, France.
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Béchet
AFPA, Association française de pédiatrie ambulatoire, 13 bis, place des Augustins, 33170 Gradignan, France.
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Vie Le Sage
ACTIV, (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 St-Maur-des-Fossés, France; CRC, CHI de Créteil, 40, avenue de Verdun, 94000 Créteil, France; AFPA, Association française de pédiatrie ambulatoire, 13 bis, place des Augustins, 33170 Gradignan, France.
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Lévy
D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D058006:General Practice; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies
D000900:Anti-Bacterial Agents