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      Prescripción de antibióticos en niños en Atención Primaria. Estudio en un área administrativa de Osakidetza-Servicio Vasco de Salud Translated title: Prescription of antibiotics in children in primary care. Study in an administrative area of Osakidetza-Basque Health Service

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          Abstract

          Introducción: según los estudios disponibles, el consumo de antibióticos en niños es elevado en España. No obstante, puede haber grandes diferencias territoriales incluso entre áreas geográficas pequeñas. El objetivo del estudio es conocer la prescripción de antibióticos en la edad pediátrica y describir sus características en el área administrativa de la Organización Sanitaria Integrada (OSI) Barrualde-Galdakao del Servicio Vasco de Salud-Osakidetza. Material y métodos: se han estudiado retrospectivamente las prescripciones antibióticas realizadas a niños de 0 a 13 años a lo largo de los años 2015, 2016 y 2017. Los datos han sido extraídos de la base de datos Presbide del Servicio Vasco de Salud-Osakidetza. Se han determinado tasas de episodios tratados con antibiótico y su prevalencia, así como tipos de antibióticos utilizados. Resultados: se han analizado 56 974 prescripciones de antibiótico dispensado a 40 824 niños a lo largo de tres años. El número de episodios tratados con antibiótico por 1000 niños/año fue de 465,20. El porcentaje de niños que recibió al menos una dispensación antibiótica/año fue de 30,72. La máxima incidencia de prescripción se dio en niños de uno y dos años (826 y 827 episodios tratados/1000 niños/año respectivamente). El 64,61% de las dispensaciones fueron de amoxicilina. Conclusión: nuestras cifras de prescripción de antibióticos en niños son elevadas en comparación con los países poco prescriptores del norte de Europa y sensiblemente inferiores a los datos disponibles de estudios hechos en España y de otros países del área mediterránea.

          Translated abstract

          Introduction: based on the current literature, the consumption of antibiotics in children is high in Spain. However, there may be large differences even between small geographic areas. The objective of the study was to establish the frequency of antibiotic prescription in the paediatric age group and describe the characteristics of these prescriptions in the in the Barrualde-Galdakao integrated health care area of the Osakidetza-Basque Health System. Methods: we made a retrospective analysis of antibiotic prescriptions made to children aged 0 to 13 years in years 2015, 2016 and 2017. We retrieved the data from the Presbide database of the Osakidetza-Basque Health System. We calculated rates of antibiotic-treated episodes and the prevalence of antibiotic use, and analysed the distribution by type of antibiotic. Results: we analysed 56 974 antibiotic prescriptions dispensed to 40 824 children over a 3-year period. The number of antibiotic-treated episodes per 1000 children/year was 465.20. The percentage of children who received at least one antibiotic per year was 30.72. The highest rates of antibiotic use occurred in children aged 1 and 2 years (826 and 827 episodes treated/1000 children/year respectively), and 64.61% of the dispensed prescriptions were for amoxicillin Conclusion: The frequency of antibiotic use in children found in our study was high compared to countries with a low frequency of antibiotic prescription in Europe and significantly lower compared to the results of other studies conducted in Spain and other Mediterranean countries.

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          Most cited references21

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          Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis

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            Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study.

            To assess the effect of community prescribing of an antibiotic for acute respiratory infection on the prevalence of antibiotic resistant bacteria in an individual child. Observational cohort study with follow-up at two and 12 weeks. General practices in Oxfordshire. 119 children with acute respiratory tract infection, of whom 71 received a beta lactam antibiotic. Antibiotic resistance was assessed by the geometric mean minimum inhibitory concentration (MIC) for ampicillin and presence of the ICEHin1056 resistance element in up to four isolates of Haemophilus species recovered from throat swabs at recruitment, two weeks, and 12 weeks. Prescribing amoxicillin to a child in general practice more than triples the mean minimum inhibitory concentration for ampicillin (9.2 microg/ml v 2.7 microg/ml, P=0.005) and doubles the risk of isolation of Haemophilus isolates possessing homologues of ICEHin1056 (67% v 36%; relative risk 1.9, 95% confidence interval 1.2 to 2.9) two weeks later. Although this increase is transient (by 12 weeks ampicillin resistance had fallen close to baseline), it is in the context of recovery of the element from 35% of children with Haemophilus isolates at recruitment and from 83% (76% to 89%) at some point in the study. The short term effect of amoxicillin prescribed in primary care is transitory in the individual child but sufficient to sustain a high level of antibiotic resistance in the population.
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              Antibiotic Use in Children - A Cross-National Analysis of 6 Countries.

              To describe the rates of pediatric antibiotic use across 6 countries on 3 continents.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                December 2020
                : 22
                : 88
                : 363-370
                Affiliations
                [3] Vizcaya orgnameOsakidetza-Servicio Vasco de Salud orgdiv1Organización Sanitaria Integrada Barrualde-Galdakao España
                [4] Vizcaya orgnameRed de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) España
                [2] Vizcaya orgnameHospital Galdakao-Usansolo orgdiv1Unidad de Investigación España
                [1] Vizcaya orgnameCentro de Salud de Iurreta España
                Article
                S1139-76322020000500007 S1139-7632(20)02208800007
                3c74375e-b070-4bb1-bede-586bcf1dddf9

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 8
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                SciELO Spain

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                Originales

                Antibiotics,Prescripción,Niños,Farmacoepidemiología,Atención Primaria,Antibióticos,Primary Care,Prescription,Pharmacoepidemiology,Children

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