Title : Antibiotic prescription practices among children with influenza or RSV infection

Abstract:

The important factor in the development of resistance to antibiotics is their overuse, especially for viral respiratory infections. Poland has been for many years a country with a problem of antibiotic overuse on compared to other European countries. The aim of the study was to find out the frequency of the antibiotic therapy administrated to children with influenza  or RSV infection in postpandemic season 2022/2023. A total of 218 children younger than 59 months seeking care for the acute respiratory tract infection was enrolled into the study.

The enrolled patients had influenza-like symptoms: fever > 38 °C, cough, and sore throat of less than 4 days duration. Nasal and pharyngeal swabs were tested for influenza A and B virus and for RSV infection with rapid antigenic tests and RT-PCR. Forty six cases of influenza were diagnosed: 34 of influenza A (H3N2) and 12 of influenza B. The incidence rate of influenza infection was 21 % in the study group. The antibiotic therapy was ordered for 72 % patients with influenza. Antibiotics were given less frequently in the outpatient setting (23 %) compared with the hospitalized patients (91 %) (p < 0.05). Fifty two cases of RSV infection were found in a study group (incidence rate 24%). Antibiotic therapy was administrated in 29 patients (25%), antibiotics were more frequently prescribed in ambulatory care patients (33%) compared to hospitalized patients (15%).

The most often administrated antibiotics were amoxicillin with clavulanic acid, cefuroxime, and amoxicillin. None of the patients in ambulatory care received oseltamivir while 82% children hospitalized with influenza receiver causative treatment with neuraminidase inhibitor. Conclusions: antibiotics were overused, while antivirals were underused among children with influenza. To improve health care quality, more efforts in the diagnosis of influenza and RSV infections and the appropriate use of antimicrobials and antivirals are required.

Audience Take Away:

• Viral respiratory tract infections in young children are very often and should be diagnosed at least with rapid  tests to confirm diagnosis
• Antibiotics may be overused in children with influenza and RSV infection which may finally increase the issue of antibiotic resistance
• Antibiotic therapy should be only started when bacterial coinfection or complication is suspected or diagnosed.

Biography:

Prof. Aneta Nitsch-Osuch is a pediatrician, epidemiologist and specialist in public health, a head of the department of Social Medicine and Public Health and deputy dean of Medical University of Warsaw, Poland. She is a member of Advisory Board of Polish Sanitary Inspection and a member of Scientific Board of the National Influenza Prevention Program, an author and co-author of more than 300 publications in a field of vaccinology, prevention of infectious diseases, epidemiology of infectious diseases and rational antibiotic therapy.