Antibiotic Prescription in Children: a Poster can Change Everything

An evaluation study on the impact of programs supporting the prescription of antibiotics conducted in the Paediatric Emergency Room from Hospital Beatriz Ângelo (HBA) and published in the latest edition of the Portuguese Journal of Paediatrics (January/March 2019), the scientific journal of the Portuguese Society of Paediatrics, concludes that simple warning measures on antibiotics prescribed for each pathology have a significant impact on the correct prescription of these medicaments.

The study, coordinated by the director of the Paediatrics Department, Paulo Oom, and signed by paediatrician Sofia Lima and operational managers Ana Escária and Daniela Duarte, all from HBA, has for basis the problem of the incorrect use of antibiotics correlated with the raise in bacterial resistance. And analyses the prescription of antibiotics by doctors of HBA Paediatrics Emergency Service, along a year, to children between six month and two years of age (over five thousand) with the diagnosis of acute otitis media.

This analysis is correlated with the effects of an intervention done along four months in that year, intervention that consisted in affixing a small poster in a visible location, in emergency consultation rooms, stating that, according to international recommendations, “in acute otitis media, whenever treatment with antibiotic is necessary, amoxicillin will be the first line treatment after neonatal period”. The same poster alerted to the fact that the prescription of other antibiotics should only happen under certain circumstances, also described.

The analysis described in this study, englobing the period before, during and after intervention, reveals that the prescription of the correct antibiotic, which was already high among emergency paediatricians, increased even more during the intervention and remained high after the poster withdrawal.

The same didn’t happen with other specialists working in the paediatrics emergency service, such as general and family medicine physicians, which prescribed much more the correct antibiotic while the poster was exposed, but afterwards returned to the former levels of amoxicillin prescription, much lesser than those of paediatricians.

The authors refer that the study shows that health professionals are influenced by programs for the optimization of antibiotics use, which can result in a more adequate prescription of these medicaments. Also according to the study of the HBA team, professionals embrace these programs spontaneously, nor considering them as a limitation to their clinical autonomy, therefore, they “should be extended, so that results won’t fade away in time”.

Read the paper:

Point-of-prescription intervention to improve the choice of antibiotic in acute otitis media in children
Paulo Oom, Sofia Costa Lima, Ana Escária, Daniela Duarte
Port J Pediatr 2019;50:12-7
doi: 10.25754/pjp.2019.13379