Analysis of the consumption of antibiotics for the treatment of respiratory tract infections in children and its compliance with national clinical guidelines

Respiratory infections are the most common infectious diseases in childhood.

The aim of the study was to analyze the use of antibiotics for the treatment of respiratory tract infections for the period from 2008 to 2010. among the infant population of the Nis region (Serbia) and the evaluation of the rational use of antibiotics in accordance with national recommendations for primary care physicians.

The source of information for this study was the pharmaceutical database of the municipality of Nis. Antibiotic prescriptions were analyzed for the following diagnoses: H65-H75 (acute otitis media, mastoiditis), D01 (acute sinusitis), D02-D03 (tonsillopharyngitis), D12-D18 (community-acquired pneumonia), D20 (acute bronchitis) , J32 (chronic sinusitis), J42 (chronic bronchitis). The consumption of antibiotics was calculated using the indicator DDD (defined daily dose) per 1000 inhabitants per day.

The most common antibiotics prescribed for the treatment of upper respiratory tract infections in children in the first 3 years of life were found to be amoxicillin (34.63; 32.50 and 31.00 DDD per 1,000 population) per day in 2008, 2009 and 2010 g., respectively).

In the treatment of middle ear infections and mastoiditis, the combination of amoxicillin with clavulanic acid was most often prescribed (60% of the total intake of antibiotics for this indication). Azithromycin was the most commonly used antibiotic to treat lower respiratory tract infections in children during the entire follow-up period (6.92; 8.20 and 7.18 DDD per 1,000 population per day in 2008, 2009 and 2010., respectively).

Thus, the results of this study demonstrated that the current practice of treating upper and lower respiratory tract infections in the pediatric population of the municipality of Nis is not entirely in accordance with national recommendations. This may be the reason for the potentially ineffective use of antibiotics. This problem requires further study, and physician training programs can affect the practice of improper use of antibiotics.