Ivanovska, Verica and van Dijk, Liset and Hek, Karin and Leufkens, Hubert and Mantel-Teeuwisse, Aukje (2015) Antibiotic prescribing for children in general practice and adherence to treatment guidelines 2010-2012. In: Utrecht WHO Winter meeting 2012, 12-13 Jan 2015, Utrecht, the Netherlands. (Unpublished)
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Abstract
Background
Over 80% of antibiotics are prescribed in general practice, mainly for viral RTIs in children. In response,
numerous efforts to improve antibiotic prescribing have been ongoing for decades. Treatment guidelines are
developed to support GP decision-making on which RTIs require antibiotics. Yet, detailed information on
adherence to RTI treatment guidelines for antibiotic prescribing in children is scarce.
Trends in antibiotic use suggest an overall reduction in antibiotic rates for children since the late 1990s. On
the other hand, antibiotics continue to be prescribed for non-specific URTIs diagnosis, and quite often as
broad-spectrum products.
The Netherlands has maintained low and stable antibiotic use in primary care. Even though, national
guidelines for RTIs are generally accepted by Dutch GPs, antibiotic prescribing is not always in accordance
with recommendations. Few studies have assessed adherence to RTI guidelines for children.
Our study explores antibiotic prescribing patterns for fever, ear and respiratory infections in Dutch children
2010 - 2012. Our objective is to determine guideline adherence in antibiotic prescribing for different
paediatric RTIs and choice of antibiotics. We also aim to examine potential variations in guideline adherence
among GPs.
Methods
We use prescribing data and children’ diagnoses (ICPC-1) from NIVEL Primary Care Database. GP prescriptions
include information on drug name (ATC), prescribing date and amount prescribed. Antibiotics are defined as
antibacterial for systemic use (ATC code J01).
We matched ICPC with clinical conditions from national guidelines. Different consultations concerning same
health problem within a pre-set time frame are linked to one disease episode. First set of outcomes measure
GP adherence to recommendations on whether or not to prescribe antibiotics for the diagnosis, while second
one evaluate antibiotic types prescribed. Outcomes are defined by disease-specific indicators for outpatient
antibiotic prescribing.
Analysis
SPSS is used to obtain overall incidence rates for each ICPC and % of disease episodes with prescribed
antibiotics. We will calculate 95% CIs for overall figures and value range for each indicator at practice level.
We will present the data by year and age groups. Multilevel analysis will be done for variability in antibiotic
prescribing quality among general practices.
| Item Type: | Conference or Workshop Item (Lecture) |
|---|---|
| Subjects: | Medical and Health Sciences > Health sciences |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Verica Ivanovska |
| Date Deposited: | 25 Apr 2017 14:04 |
| Last Modified: | 05 Nov 2018 08:10 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/17704 |
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