Accession Number	<strong>00006454-200108000-00007</strong>.
Author	OCHOA, CARLOS MD; INGLADA, LUIS MD; EIROS, JOSE MARIA MD; SOLIS, GONZALO MD; VALLANO, ANTONIO MD; GUERRA, LUIS MD; TREATMENTS, THE SPANISH STUDY GROUP ON ANTIBIOTIC
Institution	From Unidad de Investigacion, Hospital Virgen de la Concha, Zamora (CO); Servicio de Medicina Interna, Hospital Medina del Campo (LI), and Departamento de Microbiologia, Hospital Universitario (JME), Valladolid; Servicio de Pediatria, Hospital de Cabuenes, Gijon (GS); Servicio de Farmacologia Clinica, Hospital Vall d'Hebron, Barcelona (AV); and Plan Nacional del Sida, Ministerio de Sanidad y Consumo, Madrid (LG), Spain.
Title	Appropriateness of antibiotic prescriptions in community-acquired acute pediatric respiratory infections in Spanish emergency rooms.[Article]
Source	Pediatric Infectious Disease Journal. 20(8):751-758, August 2001.
Abstract	Objective. To describe the variability and appropriateness of antibiotic prescriptions in community-acquired acute respiratory infections (ARI) during childhood in Spain. Methods. A descriptive, multicenter study of variability in clinical practice was conducted by evaluating a prospective series of pediatric patients attending the emergency rooms of 11 Spanish hospitals and diagnosed with community-acquired ARI. The appropriateness of the antibiotic prescriptions was assessed by comparing our clinical practice with consensus guidelines developed for this study. Results. We collected data from 6,249 ARI emergencies studied on 30 separate days. Antibiotics were prescribed in 58.7% of the ARI (bronchiolitis, 11.5%; bronchitis, 40.2%; pharyngotonsillitis, 80.9%; nonspecified ARI, 34.8%; pneumonia, 92.4%; otitis, 93.4%; sinusitis, 92.6%). The most commonly used antibiotics were amoxicillin/clavulanate (33.2%), amoxicillin (30.2%), cefuroxime axetil (8.5%) and azithromycin (6%). According to the consensus guidelines developed for this study, therapy was considered to be appropriate in 63.1% of the ARI (first choice, 52.1%; alternative choice, 11.0%) and inappropriate in 36.9%. The percentages of inappropriate prescription according to ARI groups were: bronchiolitis, 11.5%; bronchitis, 31.5%; pharyngotonsillitis, 54.8%; nonspecified ARI, 34.7%; pneumonia, 13.9%; otitis, 25.6%; and sinusitis, 22.2%. Conclusions. There is excessive use of antibiotics in acute respiratory infections that are presumably viral in origin. An important number of ARI of potentially bacterial origin are treated with antibiotics that are not sufficiently efficacious or that have a broader spectrum than necessary. (C) 2001 Lippincott Williams & Wilkins, Inc.