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Factors associated with inappropriateness of antibiotic prescriptions for acutely ill children presenting to ambulatory care in high-income countries: a systematic review and meta-analysis.
Dillen, Hannelore; Wouters, Jo; Snijders, Daniëlle; Wynants, Laure; Verbakel, Jan Y.
Afiliación
  • Dillen H; EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium.
  • Wouters J; Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium.
  • Snijders D; Faculty of Medicine, KU Leuven, 49 Herestraat, Leuven, 3000, Belgium.
  • Wynants L; Faculty of Medicine, KU Leuven, 49 Herestraat, Leuven, 3000, Belgium.
  • Verbakel JY; EPI-Centre, Department of Public Health and Primary Care, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium.
J Antimicrob Chemother ; 79(3): 498-511, 2024 03 01.
Article en En | MEDLINE | ID: mdl-38113395
ABSTRACT

BACKGROUND:

Acutely ill children are at risk of unwarranted antibiotic prescribing. Data on the appropriateness of antibiotic prescriptions provide insights into potential tailored interventions to promote antibiotic stewardship.

OBJECTIVES:

To examine factors associated with the inappropriateness of antibiotic prescriptions for acutely ill children presenting to ambulatory care in high-income countries.

METHODS:

On 8 September 2022, we systematically searched articles published since 2002 in MEDLINE, Embase, CENTRAL, Web of Science, and grey literature databases. We included studies with acutely ill children presenting to ambulatory care settings in high-income countries reporting on the appropriateness of antibiotic prescriptions. The quality of the studies was evaluated using the Appraisal tool for Cross-Sectional Studies and the Newcastle-Ottawa Scale. Pooled ORs were calculated using random-effects models. Meta-regression, sensitivity and subgroup analysis were also performed.

RESULTS:

We included 40 articles reporting on 30 different factors and their association with inappropriate antibiotic prescribing. 'Appropriateness' covered a wide range of definitions. The following factors were associated with increased inappropriate antibiotic prescribing acute otitis media diagnosis [pooled OR (95% CI) 2.02 (0.54-7.48)], GP [pooled OR (95% CI) 1.38 (1.00-1.89)] and rural setting [pooled OR (95% CI) 1.47 (1.08-2.02)]. Older patient age and a respiratory tract infection diagnosis have a tendency to be positively associated with inappropriate antibiotic prescribing, but pooling of studies was not possible.

CONCLUSIONS:

Prioritizing acute otitis media, GPs, rural areas, older children and respiratory tract infections within antimicrobial stewardship programmes plays a vital role in promoting responsible antibiotic prescribing. The implementation of a standardized definition of appropriateness is essential to evaluate such programmes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Otitis Media / Infecciones del Sistema Respiratorio / Prescripción Inadecuada / Antibacterianos Tipo de estudio: Systematic_reviews Límite: Child / Humans Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Otitis Media / Infecciones del Sistema Respiratorio / Prescripción Inadecuada / Antibacterianos Tipo de estudio: Systematic_reviews Límite: Child / Humans Idioma: En Revista: J Antimicrob Chemother Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido