Ambulantna poraba antibiotikov pri otrocih v Sloveniji

Abstract

Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015.Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region.Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists.Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

Increased adherence to treatment guidelines for lower urinary tract infections in out–of–hours primary care settings following a simple intervention strategy

“…As the main outcome variable, we used the vari able "adherence to guidelines." This variable had a positive value in the case of a correct first choice of antibiotic and in case of correct treatment duration (trimethoprim/sulphametoxazole [160/800 mg eve ry 12 hours for 3 days] and nitrofurantoin [100 mg every 12 hours for 5 days] (17,18).…”

“…Trimethoprim-sulfamethoxazole is recommended as the drug of choice at a dose of 160/800 mg ev ery 12 hours for 3 days. In 2011, the Urology De partment recommended new guidelines with the recommendation of nitrofurantoin as the drug of choice at a dose of 100 mg every 12 hours for 5 days (18). In parts of Slovenia, where the prevalence of resistance to trimethoprim-sulfamethoxazole is be low 20%, trimethoprim-sulfamethoxazole can also serve as the drug of choice.…”