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Med Mal Infect. 2014 Mar;44(3):102-6. doi: 10.1016/j.medmal.2014.01.005. Epub 2014 Mar 11.

Impact of 2011 French guidelines on antibiotic prescription for acute otitis media in infants.

Author information

1
Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 94000 Créteil, France.
2
Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
3
Service des urgences pédiatriques, université Pierre-et-Marie-Curie, hôpital Armand-Trousseau, AP-HP, 75012 Paris, France.
4
Association française de pédiatrie ambulatoire (AFPA), 30400 Villeneuve-les-Avignons, France.
5
Unité d'épidémiologie clinique Inserm CIE 5, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 75019 Paris, France.
6
Service de pédiatrie, université Paris-Sud, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France.
7
Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France. Electronic address: francois.angoulvant@rdb.aphp.fr.

Abstract

OBJECTIVE:

In 2011, new guidelines on antibiotic prescription for acute otitis media (AOM) were published in France to decrease the use of third generation cephalosporins that promote the carriage of extended-spectrum beta-lactamase producing Escherichia coli. Our objective was to assess the impact of the 2011 French recommendations on the type of antibiotics prescribed for AOM.

METHODS:

Fourteen thousand six hundred and sixty-one children, 6 to 24 months of age, presenting with AOM were included in 2 studies, between November 1, 2009 and October 31, 2012. The first one was conducted with the support of 62 private practice pediatricians; the second one was conducted in 7 pediatric emergency departments. Three periods of 1 year each were defined.

RESULTS:

Antibiotics were prescribed in 12,471 (85.1%) of cases of AOM during the study period. Amoxicillin prescriptions was multiplied by 25, between the first year (2.6%) and the last year (66.1%). Conversely, prescriptions of cefpodoxime proxetil and amoxicillin-clavulanic acid decreased from 33.6% and 62.0% in the first year to 5.2% and 27.7% in the last year, respectively. This trend was observed in both private practices and in the pediatric emergency departments.

CONCLUSION:

Amoxicillin became the most frequently prescribed antibiotic for AOM in 2012, complying with the 2011 French guidelines, while the proportion of prescribed broad-spectrum antibiotics decreased. Our study highlights the importance of guidelines to decrease the prescription of broad-spectrum antibiotics, a crucial factor in the prevention of antibiotic resistance.

KEYWORDS:

Acute otitis media; Antibiotics; Antibiotiques; Otites moyennes aiguës; Pediatric emergency department; Urgences pédiatriques

PMID:
24630597
DOI:
10.1016/j.medmal.2014.01.005
[Indexed for MEDLINE]

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