Antibiotic misuse in respiratory tract infections in children and adults—a prospective, multicentre study (TAILORED Treatment

Collection Location Koleksi E-book & E-Journal Perpustakaan Pusat Unila
Edition Vol. 38, Issue 3
Call Number
ISBN/ISSN 1435-4373
Author(s) Van Houten, Chantal B...[et al.]
Subject(s) Biomedicine
Classification NONE
Series Title
GMD E-Journal
Language English
Publisher Springer
Publishing Year 2019
Publishing Place Switzerland
Collation
Abstract/Notes Abstract
Respiratory tract infections (RTI) are more commonly caused by viral pathogens in children than in adults. Surprisingly, little is
known about antibiotic use in children as compared to adults with RTI. This prospective study aimed to determine antibiotic
misuse in children and adults with RTI, using an expert panel reference standard, in order to prioritise the target age population for
antibiotic stewardship interventions. We recruited children and adults who presented at the emergency department or were
hospitalised with clinical presentation of RTI in The Netherlands and Israel. A panel of three experienced physicians adjudicated
a reference standard diagnosis (i.e. bacterial or viral infection) for all the patients using all available clinical and laboratory
information, including a 28-day follow-up assessment. The cohort included 284 children and 232 adults with RTI (median age,
1.3 years and 64.5 years, respectively). The proportion of viral infections was larger in children than in adults (209(74%) versus
89(38%), p < 0.001). In case of viral RTI, antibiotics were prescribed (i.e. overuse) less frequently in children than in adults (77/
209 (37%) versus 74/89 (83%), p < 0.001). One (1%) child and three (2%) adults with bacterial infection were not treated with
antibiotics (i.e. underuse); all were mild cases. This international, prospective study confirms major antibiotic overuse in patients
with RTI. Viral infection is more common in children, but antibiotic overuse is more frequent in adults with viral RTI. Together,
these findings support the need for effective interventions to decrease antibiotic overuse in RTI patients of all ages.
Keywords Antibiotic use . Pulmonology . Infectious diseases . Respiratory tract infections
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