Use of antibiotics in the health care unit: 2015 Pelotas Birth Cohort

Abstract

OBJECTIVE:To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS:A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS:A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS:Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.

Antibiotic Prescription and Consumption in Brazil: Impact in the Global Health

“…Epidemiologic aspects related to antibiotic use were evaluated in 1,044 children of Pelotas, Rio Grande do Sul: only 45% had an antibiotic prescription. Children with brown, yellow, or indigenous skin color had taken 2.5 times more antibiotics than white ones; children of mothers with 12 or more years of schooling used 83.0% fewer antibiotics than those of mothers with up to 4 years of schooling [14]. Relevant aspects associated with antibiotics consumption by the Brazilian population have been summarized in (Table 2).…”

“…The most frequent clinical indication for which antibiotics were prescribed and consumed by the Brazilian population was respiratory tract infections, although, in many cases, the infection may have been of viral origin [4,7,8,12,13,14]. The mistaken use of an-tibiotics to treat undetermined fever, viral infections and allergies and the recommendation of antibiotic use by family and friends based on symptoms and without a medical prescription are strong pieces of evidence of the indiscriminate use of antibiotics in Brazil.…”

“…The mistaken use of an-tibiotics to treat undetermined fever, viral infections and allergies and the recommendation of antibiotic use by family and friends based on symptoms and without a medical prescription are strong pieces of evidence of the indiscriminate use of antibiotics in Brazil. Antibiotic prescriptions to treat nonbacterial infections lead to unnecessary consumption of antibiotics [12,13,14].…”

“…In addition to the adverse effects that the antibiotic can cause in the patient, overuse can lead the patient to become ill from overdose, and underdoses can select resistant strains of bacteria among the sensitive ones impairing the treatment of a later bacterial infection. Amoxicillin was the most prescript consumed, and self-medicated antibiotic in Brazil [4,7,8,12,14]. This beta-lactam has been used to treat most community-acquired infections, and the isolation of Gram-positive and Gram-negative bacterial pathogens resistant to amoxicillin is very common in our midst [6].…”