Encuesta sobre el uso racional de antibióticos en atención primaria

Casaní Martínez, C.; Calvo Rigual, F.; Peris Vidal, A.; de Lavida Mulero, T. Álvarez; Díez Domingo, J.; Graullera Millas, M.; Úbeda Sansano, I.

doi:10.1016/S1695-4033(03)77984-3

Información del artículo

Objetivo

Conocer los hábitos de prescripción de antibióticos de los pediatras de la Comunidad Valenciana en la otitis media aguda (OMA) y la faringoamigdalitis y la relación padres-pediatra respecto a los antimicrobianos.

Método

Se seleccionaron al azar 400 miembros de la Sociedad Valenciana de Pediatría. Cuestionario semiestructurado de respuestas no excluyentes remitido por correo y nuevo envío si no se obtuvo respuesta. Se garantizó la confidencialidad de la información.

Resultados

De las 400 encuestas remitidas, 143 (35,8 %) fueron cumplimentadas. El 88,1 % eran pediatras y el 51,1 % trabajaban en un equipo de atención primaria. En la OMA, el 48,3 % indicaba antibiótico en todos los casos, recetándolo el 94,5 % si la fiebre y la otalgia persistían más de 48 h. La amoxicilina-ácido clavulánico fue el antibiótico más prescrito (63,6 %). En la faringoamigdalitis, menos del 10 % administraban tratamiento empírico, siendo la amoxicilina el antibiótico más utilizado (54,6 %). La fiebre, la odinofagia y las adenopatías (69,5 %) o el exudado amigdalar (62,5 %) fueron los criterios para indicar la antibioticoterapia. El aspecto que más contribuye al uso inapropiado de antibióticos es la presión asistencial y el educar a los padres el que más ayudaría a reducir este uso inapropiado.

Conclusiones

La utilización de antibióticos en el tratamiento de la OMA es una práctica frecuente. La amoxicilina-ácido clavulánico para la otitis y la amoxicilina en la faringoamigdalitis fueron los antibióticos más prescritos. La educación sanitaria de los padres y reducir la presión asistencial disminuirían el consumo inadecuado de antibióticos.

Palabras clave:

Otitis media aguda (OMA)

Faringoamigdalitis

Uso ra-cional de antibióticos

Pediatría

Infancia

Objective

To identify pediatricians‚ antibiotic prescribing habits in acute otitis media and tonsillopharyngitis and to deter-mine the interaction between parents and pediatricians concerning antibiotic use in theAutonomous Community of Valencia (Spain).

Method

Four hundred members of the Valencian Society of Pediatrics were randomly selected. A semi-structured ques-tionnaire with non-excluding answers was sent by mail and, when responses were not obtained, a second one was sent. The confidentiality of the information was guaranteed.

Results

Of 400 questionnaires sent, 143 (35.8%) were completed; 88.1 % were completed by pediatricians and 51.1 % by primary care workers. A total of 48.3% of pediatricians used antibiotics in all cases of acute otitis media and 94.5% prescribed them when fever and otalgia persisted for more than 48 hours. Amoxicillin-clavulanate was the most frequently prescribed antibiotic (63.6%). Less than 10 % of pediatricians prescribed antibiotics as empirical treatment in tonsillopharyngitis; amoxicillin was the most frequently prescribed antibiotic (54.6 %). Indications for antibiotic treatment were fever, odynophagia and adenomegaly (69.5 %) and tonsillar exudate (62.5 %). Inappropriate antibiotic use was mainly due to excess workload. Providing health education to parents could be the best way of reducing inappropriate use.

Conclusions

Antibiotic use is frequent in the treatment of acute otitis media. Amoxicillin-clavulanate and amoxicillin were the most frequently prescribed antibiotics in tonsillopharyngitis. Providing health education to parents and reducing pediatricians‚ workload would decrease inappropriate antibiotic use.

Key words:

Acute otitis media

Tonsillopharyngitis

Judicious use of antibiotics

Pediatrics

Childhood

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