Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments.
Identifieur interne : 000672 ( Main/Exploration ); précédent : 000671; suivant : 000673Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments.
Auteurs : C. Ochoa ; J M Eiros ; L. Inglada ; A. Vallano ; L. GuerraSource :
- The Journal of infection [ 0163-4453 ] ; 2000.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse de regroupements (MeSH), Antibactériens (administration et posologie), Antibactériens (usage thérapeutique), Association amoxicilline-clavulanate de potassium (administration et posologie), Association amoxicilline-clavulanate de potassium (usage thérapeutique), Conférences de consensus comme sujet (MeSH), Céfuroxime (administration et posologie), Céfuroxime (usage thérapeutique), Espagne (MeSH), Femelle (MeSH), Humains (MeSH), Infections de l'appareil respiratoire (traitement médicamenteux), Maladie aigüe (MeSH), Mâle (MeSH), Ordonnances médicamenteuses (statistiques et données numériques), Otite (traitement médicamenteux), Services des urgences médicales (statistiques et données numériques), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Études rétrospectives (MeSH), Études transversales (MeSH).
- MESH :
- administration et posologie : Antibactériens, Association amoxicilline-clavulanate de potassium, Céfuroxime.
- statistiques et données numériques : Ordonnances médicamenteuses, Services des urgences médicales.
- traitement médicamenteux : Infections de l'appareil respiratoire, Otite.
- usage thérapeutique : Antibactériens, Association amoxicilline-clavulanate de potassium, Céfuroxime.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de regroupements, Conférences de consensus comme sujet, Espagne, Femelle, Humains, Maladie aigüe, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études rétrospectives, Études transversales.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Acute Disease (MeSH), Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Amoxicillin-Potassium Clavulanate Combination (administration & dosage), Amoxicillin-Potassium Clavulanate Combination (therapeutic use), Anti-Bacterial Agents (administration & dosage), Anti-Bacterial Agents (therapeutic use), Cefuroxime (administration & dosage), Cefuroxime (therapeutic use), Cluster Analysis (MeSH), Consensus Development Conferences as Topic (MeSH), Cross-Sectional Studies (MeSH), Drug Prescriptions (statistics & numerical data), Emergency Medical Services (statistics & numerical data), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Otitis (drug therapy), Respiratory Tract Infections (drug therapy), Retrospective Studies (MeSH), Spain (MeSH).
- MESH :
- chemical , administration & dosage : Amoxicillin-Potassium Clavulanate Combination, Anti-Bacterial Agents, Cefuroxime.
- chemical , therapeutic use : Amoxicillin-Potassium Clavulanate Combination, Anti-Bacterial Agents, Cefuroxime.
- geographic : Spain.
- drug therapy : Otitis, Respiratory Tract Infections.
- statistics & numerical data : Drug Prescriptions, Emergency Medical Services.
- Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Cluster Analysis, Consensus Development Conferences as Topic, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
OBJECTIVE
This study aims to ascertain the variability in the use of antibiotics for the treatment of acute respiratoryinfections in several hospital emergency services in Spain, as well as the appropriateness of antibiotics prescription through evaluation by a panel of experts using available scientific evidence.
METHOD
A cross-sectional study was carried out in the emergency services of 10 hospitals in different Spanish regions. We chose patients diagnosed as having acute respiratory infection, aged over 14 years. Among the collected variables were: type of respiratory infection, antibiotic prescription, comorbidity, qualification of the prescribing doctor and hospital admission. The consensus conference held by a panel of experts established first choice treatment and the alternative and inappropriate use for each respiratory infection, based on the available scientific evidence. All the observed prescriptions in our study were classified according to this pattern.
RESULTS
A sample of 2899 acute respiratory infections was studied (5.5% of all emergencies). Antibacterial agent treatment was prescribed in 82.6% of these, varying according to the infection between 98.5% of pneumonias and 49% of croup-influenza-common cold. The most commonly used antibiotics were amoxicillin-clavulanate and cefuroxime. The global percentage of inappropriate prescription was 40.5% (95% CI; 35.4-45.5). The prescriptions were inappropriate in 16.9% of cases of pharyngotonsillitis, 17.8% of chronic bronchitis, 26.9% of acute bronchitis, 29.3% of pneumonias, 30.8% of otitis and sinusitis and in 70.8% of croup, flu, common cold and non-specified infections. Significant variability among participating centres was observed, both in choice of antibiotics and in their degree of appropriateness.
CONCLUSIONS
There is excessive use of antimicrobial drugs in acute respiratory infections, and the majority are used for viral infections. There is indiscriminate use of broad spectrum antibiotics, which are valid in some infections but clearly inappropriate in others. Similarly, there are important differences in the choice of antibiotics and their degree of appropriateness among hospitals.
DOI: 10.1053/jinf.2000.0689
PubMed: 10942644
Affiliations:
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Guerra</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2000">2000</date><idno type="RBID">pubmed:10942644</idno><idno type="pmid">10942644</idno><idno type="doi">10.1053/jinf.2000.0689</idno><idno type="wicri:Area/Main/Corpus">00666</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">00666</idno><idno type="wicri:Area/Main/Curation">000666</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000666</idno><idno type="wicri:Area/Main/Exploration">000666</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments.</title><author><name sortKey="Ochoa, C" sort="Ochoa, C" uniqKey="Ochoa C" first="C" last="Ochoa">C. Ochoa</name><affiliation><nlm:affiliation>Unidad de Investigación, Hospital Virgen de la Concha, Zamora.</nlm:affiliation><wicri:noCountry code="subField">Zamora</wicri:noCountry></affiliation></author><author><name sortKey="Eiros, J M" sort="Eiros, J M" uniqKey="Eiros J" first="J M" last="Eiros">J M Eiros</name></author><author><name sortKey="Inglada, L" sort="Inglada, L" uniqKey="Inglada L" first="L" last="Inglada">L. Inglada</name></author><author><name sortKey="Vallano, A" sort="Vallano, A" uniqKey="Vallano A" first="A" last="Vallano">A. Vallano</name></author><author><name sortKey="Guerra, L" sort="Guerra, L" uniqKey="Guerra L" first="L" last="Guerra">L. Guerra</name></author></analytic><series><title level="j">The Journal of infection</title><idno type="ISSN">0163-4453</idno><imprint><date when="2000" type="published">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Disease (MeSH)</term><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Amoxicillin-Potassium Clavulanate Combination (administration & dosage)</term><term>Amoxicillin-Potassium Clavulanate Combination (therapeutic use)</term><term>Anti-Bacterial Agents (administration & dosage)</term><term>Anti-Bacterial Agents (therapeutic use)</term><term>Cefuroxime (administration & dosage)</term><term>Cefuroxime (therapeutic use)</term><term>Cluster Analysis (MeSH)</term><term>Consensus Development Conferences as Topic (MeSH)</term><term>Cross-Sectional Studies (MeSH)</term><term>Drug Prescriptions (statistics & numerical data)</term><term>Emergency Medical Services (statistics & numerical data)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Otitis (drug therapy)</term><term>Respiratory Tract Infections (drug therapy)</term><term>Retrospective Studies (MeSH)</term><term>Spain (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Analyse de regroupements (MeSH)</term><term>Antibactériens (administration et posologie)</term><term>Antibactériens (usage thérapeutique)</term><term>Association amoxicilline-clavulanate de potassium (administration et posologie)</term><term>Association amoxicilline-clavulanate de potassium (usage thérapeutique)</term><term>Conférences de consensus comme sujet (MeSH)</term><term>Céfuroxime (administration et posologie)</term><term>Céfuroxime (usage thérapeutique)</term><term>Espagne (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Infections de l'appareil respiratoire (traitement médicamenteux)</term><term>Maladie aigüe (MeSH)</term><term>Mâle (MeSH)</term><term>Ordonnances médicamenteuses (statistiques et données numériques)</term><term>Otite (traitement médicamenteux)</term><term>Services des urgences médicales (statistiques et données numériques)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Études rétrospectives (MeSH)</term><term>Études transversales (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Amoxicillin-Potassium Clavulanate Combination</term><term>Anti-Bacterial Agents</term><term>Cefuroxime</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Amoxicillin-Potassium Clavulanate Combination</term><term>Anti-Bacterial Agents</term><term>Cefuroxime</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antibactériens</term><term>Association amoxicilline-clavulanate de potassium</term><term>Céfuroxime</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Otitis</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Drug Prescriptions</term><term>Emergency Medical Services</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Ordonnances médicamenteuses</term><term>Services des urgences médicales</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections de l'appareil respiratoire</term><term>Otite</term></keywords><keywords scheme="MESH" qualifier="usage 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scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>This study aims to ascertain the variability in the use of antibiotics for the treatment of acute respiratoryinfections in several hospital emergency services in Spain, as well as the appropriateness of antibiotics prescription through evaluation by a panel of experts using available scientific evidence.</p></div><div type="abstract" xml:lang="en"><p><b>METHOD</b></p><p>A cross-sectional study was carried out in the emergency services of 10 hospitals in different Spanish regions. We chose patients diagnosed as having acute respiratory infection, aged over 14 years. Among the collected variables were: type of respiratory infection, antibiotic prescription, comorbidity, qualification of the prescribing doctor and hospital admission. The consensus conference held by a panel of experts established first choice treatment and the alternative and inappropriate use for each respiratory infection, based on the available scientific evidence. All the observed prescriptions in our study were classified according to this pattern.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>A sample of 2899 acute respiratory infections was studied (5.5% of all emergencies). Antibacterial agent treatment was prescribed in 82.6% of these, varying according to the infection between 98.5% of pneumonias and 49% of croup-influenza-common cold. The most commonly used antibiotics were amoxicillin-clavulanate and cefuroxime. The global percentage of inappropriate prescription was 40.5% (95% CI; 35.4-45.5). The prescriptions were inappropriate in 16.9% of cases of pharyngotonsillitis, 17.8% of chronic bronchitis, 26.9% of acute bronchitis, 29.3% of pneumonias, 30.8% of otitis and sinusitis and in 70.8% of croup, flu, common cold and non-specified infections. Significant variability among participating centres was observed, both in choice of antibiotics and in their degree of appropriateness.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>There is excessive use of antimicrobial drugs in acute respiratory infections, and the majority are used for viral infections. There is indiscriminate use of broad spectrum antibiotics, which are valid in some infections but clearly inappropriate in others. Similarly, there are important differences in the choice of antibiotics and their degree of appropriateness among hospitals.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">10942644</PMID><DateCompleted><Year>2000</Year><Month>10</Month><Day>13</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0163-4453</ISSN><JournalIssue CitedMedium="Print"><Volume>41</Volume><Issue>1</Issue><PubDate><Year>2000</Year><Month>Jul</Month></PubDate></JournalIssue><Title>The Journal of infection</Title><ISOAbbreviation>J. Infect.</ISOAbbreviation></Journal><ArticleTitle>Assessment of antibiotic prescription in acute respiratory infections in adults. The Spanish Study Group on Antibiotic Treatments.</ArticleTitle><Pagination><MedlinePgn>73-83</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">This study aims to ascertain the variability in the use of antibiotics for the treatment of acute respiratoryinfections in several hospital emergency services in Spain, as well as the appropriateness of antibiotics prescription through evaluation by a panel of experts using available scientific evidence.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">A cross-sectional study was carried out in the emergency services of 10 hospitals in different Spanish regions. We chose patients diagnosed as having acute respiratory infection, aged over 14 years. Among the collected variables were: type of respiratory infection, antibiotic prescription, comorbidity, qualification of the prescribing doctor and hospital admission. The consensus conference held by a panel of experts established first choice treatment and the alternative and inappropriate use for each respiratory infection, based on the available scientific evidence. All the observed prescriptions in our study were classified according to this pattern.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A sample of 2899 acute respiratory infections was studied (5.5% of all emergencies). Antibacterial agent treatment was prescribed in 82.6% of these, varying according to the infection between 98.5% of pneumonias and 49% of croup-influenza-common cold. The most commonly used antibiotics were amoxicillin-clavulanate and cefuroxime. The global percentage of inappropriate prescription was 40.5% (95% CI; 35.4-45.5). The prescriptions were inappropriate in 16.9% of cases of pharyngotonsillitis, 17.8% of chronic bronchitis, 26.9% of acute bronchitis, 29.3% of pneumonias, 30.8% of otitis and sinusitis and in 70.8% of croup, flu, common cold and non-specified infections. Significant variability among participating centres was observed, both in choice of antibiotics and in their degree of appropriateness.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">There is excessive use of antimicrobial drugs in acute respiratory infections, and the majority are used for viral infections. There is indiscriminate use of broad spectrum antibiotics, which are valid in some infections but clearly inappropriate in others. Similarly, there are important differences in the choice of antibiotics and their degree of appropriateness among hospitals.</AbstractText><CopyrightInformation>Copyright 2000</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ochoa</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Unidad de Investigación, Hospital Virgen de la Concha, Zamora.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eiros</LastName><ForeName>J M</ForeName><Initials>JM</Initials></Author><Author ValidYN="Y"><LastName>Inglada</LastName><ForeName>L</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Vallano</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Guerra</LastName><ForeName>L</ForeName><Initials>L</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Infect</MedlineTA><NlmUniqueID>7908424</NlmUniqueID><ISSNLinking>0163-4453</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>74469-00-4</RegistryNumber><NameOfSubstance UI="D019980">Amoxicillin-Potassium Clavulanate Combination</NameOfSubstance></Chemical><Chemical><RegistryNumber>O1R9FJ93ED</RegistryNumber><NameOfSubstance UI="D002444">Cefuroxime</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000208" MajorTopicYN="N">Acute Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019980" MajorTopicYN="N">Amoxicillin-Potassium Clavulanate Combination</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002444" MajorTopicYN="N">Cefuroxime</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016000" MajorTopicYN="N">Cluster Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003245" MajorTopicYN="N">Consensus Development Conferences as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011307" MajorTopicYN="N">Drug Prescriptions</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004632" MajorTopicYN="N">Emergency Medical Services</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010031" MajorTopicYN="N">Otitis</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2000</Year><Month>8</Month><Day>16</Day><Hour>11</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2000</Year><Month>10</Month><Day>21</Day><Hour>11</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2000</Year><Month>8</Month><Day>16</Day><Hour>11</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">10942644</ArticleId><ArticleId IdType="doi">10.1053/jinf.2000.0689</ArticleId><ArticleId IdType="pii">S0163445300906893</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list></list><tree><noCountry><name sortKey="Eiros, J M" sort="Eiros, J M" uniqKey="Eiros J" first="J M" last="Eiros">J M Eiros</name><name sortKey="Guerra, L" sort="Guerra, L" uniqKey="Guerra L" first="L" last="Guerra">L. Guerra</name><name sortKey="Inglada, L" sort="Inglada, L" uniqKey="Inglada L" first="L" last="Inglada">L. Inglada</name><name sortKey="Ochoa, C" sort="Ochoa, C" uniqKey="Ochoa C" first="C" last="Ochoa">C. Ochoa</name><name sortKey="Vallano, A" sort="Vallano, A" uniqKey="Vallano A" first="A" last="Vallano">A. Vallano</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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