[Changes in antibiotics prescription in primary care].

Background: Bacterial resistance to antimicrobial drugs constitutes a considerable problem in clinical practice. Overprescribing of these drugs contributes to bacterial resistance and current literature shows a growing interest in the rationalization of antibiotic use.

Objectives: To observe the appropriateness of antibiotic prescriptions to children in an outpatient primary care setting, before and after a critical analysis of prescribing habits was performed.

Patients and methods: Children aged 0-4 years attending the outpatient pediatric clinic were surveyed in two different periods: 1997 and 2000. The number of visits, infectious and respiratory diseases observed, and courses of antibiotics prescribed was determined.

Results: A total of 456 children, 2,339 diseases, and 829 antibiotic prescriptions were included. Several differences were observed between the two periods: the number of antibiotic courses administered to each child in one year averaged 2.3 in the first period and 1.5 in the second (p < 0.001). The number of processes receiving antibiotic prescription decreased from 38.8 % to 31.7 % (p < 0.001). The appropriateness of the decision to treat increased from 85.1 % to 93.3 % (p < 0.001), and the appropriateness of the antibiotic prescribed increased from 56.3 % to 78.7 % (p < 0.001). The most frequently diagnosed infectious diseases were common cold, tonsillopharyngitis, otitis and bronchitis. The most frequently prescribed antibiotic drugs were amoxicillin, amoxicillin-clavulanate and V penicillin.

Conclusions: Physicians' knowledge of their own antibiotics prescription profiles with subsequent critical comparative analysis with current literature on the subject can help to modify prescribing habits.