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Impact of implementing French antibiotic guidelines for acute respiratory-tract infections in a paediatric emergency department, 2005–2009

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Abstract

Acute respiratory tract infections (ARTIs) are the main reason for antibiotic prescription in children. In 2005, the French Drug Agency published guidelines to minimise inappropriate use of antibiotics for ARTI. The purpose of this study was to assess the impact of implementing these guidelines in a paediatric emergency department. We retrospectively analysed data collected prospectively in a French paediatric emergency department from November 2005 (date of guideline implementation) to October 2009. For each child diagnosed with ARTI, we collected age, diagnosis, and prescribed antibiotics. We computed antibiotic prescription rates in the study population. During the study period, 53,055 children were diagnosed with ARTI and 59% of the 22,198 antibiotic prescriptions given at discharge were related to ARTI. The proportion of ARTI patients given antibiotic prescriptions fell from 32.1% during the first year to 21% in year 4 (p < 10−4, Cochran-Armitage test). Amoxicillin-clavulanic acid and amoxicillin accounted for 50% and 34% of antibiotic prescriptions for ARTI, respectively. French antibiotic guidelines led to significant decreases in antibiotic prescription for ARTI in our paediatric emergency department.

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Abbreviations

AOM:

Acute otitis media

ARTI:

Acute respiratory tract infections

ICD-10-CM:

International Classification of Diseases, Tenth Revision, Clinical Modification

PED:

Paediatric emergency department

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Acknowledgement

We thank Ms. Géraldine Sursin for her help on computer procedures and to an anonymous reviewer for her/his numerous constructive remarks.

Funding

None.

Conflict of interest

None.

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Authors and Affiliations

  1. Service d’Accueil des Urgences Pédiatriques, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris and Université Paris 7 Denis Diderot, 48 Boulevard Sérurier, 75019, Paris, France

    F. Angoulvant, H. Bellanger, X. Bellettre, L. Morin, M. Aptecar, G. Galli-Gibertini & J.-C. Mercier

  2. Unité d’Epidémiologie Clinique and INSERM CIE-5, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris and Université Paris 7 Denis Diderot, Paris, France

    F. Angoulvant, H. Abdoul & C. Alberti

  3. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    D. Skurnik

  4. Pharmacie, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris and Université Paris 5 Descartes, Paris, France

    O. Bourdon

  5. Service de Microbiologie, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris and Université Paris 7 Denis Diderot, Paris, France

    C. Doit

  6. Service de Pédiatrie Générale, Hôpital Robert Debré, Assistance Publique – Hôpitaux de Paris and Université Paris 7 Denis Diderot, Paris, France

    A. Faye

  7. Service de Pédiatrie, Centre Hospitalier Intercommunal, Créteil, France

    R. Cohen

Authors
  1. F. Angoulvant
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  2. D. Skurnik
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  3. H. Bellanger
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  4. H. Abdoul
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  5. X. Bellettre
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  6. L. Morin
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  7. M. Aptecar
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  8. G. Galli-Gibertini
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  9. O. Bourdon
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  10. C. Doit
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  11. A. Faye
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  12. J.-C. Mercier
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  13. R. Cohen
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  14. C. Alberti
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Corresponding author

Correspondence to F. Angoulvant.

Additional information

David Skurnik and Hélène Bellanger contributed equally to the study.

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Angoulvant, F., Skurnik, D., Bellanger, H. et al. Impact of implementing French antibiotic guidelines for acute respiratory-tract infections in a paediatric emergency department, 2005–2009. Eur J Clin Microbiol Infect Dis 31, 1295–1303 (2012). https://doi.org/10.1007/s10096-011-1442-4

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  • DOI: https://doi.org/10.1007/s10096-011-1442-4

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