Antibiotic prescribing in the primary paediatric care in Central Eastern Europe common history with different approaches
Abstract number: 10.1111/j.1198-743X.2004.902_s343.x
ESAC project shows important differences of antibiotic consumption in ambulatory care in CEE countries. Antibiotic consumption in the Czech Republic (CZ) and Hungary (HU) is about 20 DID, in Slovakia (SK) and Poland (PL) is about 25 DID. While the consumption in CZ, HU and SK is stable, there is ongoing increase in PL. Prevalence of resistance is also different, occurrence of penicillin-resistant pneumococci is high in SK and HU, low rates are in CZ and PL. Growing resistance of S. pyogenes to macrolides, especially in primary paediatric care, indicates changes in prescribing. ESAC consumption data describe current, relatively stable situation, but the most important changes in antibiotic prescribing were happened during early 1990s, when the healthcare system was totally transformed in all of former members of Soviet block. As example, in CZ, there was observed rapid increase of total consumption (1419 DID) including deep changes of its structure (decrease of penicillins, increase of broad spectrum drugs). Changes in consumption were followed with growing resistance. These countries are under strong marketing pressure from the pharmaceutical industry, without experience on how to overcome it. It is extremely important to support the implementation of independent and effective intervention methods for improving antibiotic prescribing in the region. Project on auditing antibiotic prescribing in primary paediatric care was established in the late 1990s in the Czech Republic and Slovakia. The same protocol and methodology was applied for repeated multicentric studies, performed in several regions. Although both countries have common history in the same state for more than 70 years, and transformation of healthcare system was very similar, antibiotic prescribing practices and also resistance rates are extremely different. Antibiotic prescribing for acute respiratory illness is twice more frequent in SK, prescribing for common cold is extremely rare in CZ, while in SK is common. Audits successfully identified proportion and reasons of inappropriate prescriptions, when acute bronchitis is the most important for antibiotic misuse. Although CZ situation looks better, the proportion of inadequate prescribing is 50% as a minimum. The most of repeatedly audited GPs significantly improved their practice during the time. Based on the 5 years of experiences, there is good opportunity to extend auditing as a routine tool for interventions."
|Session name:||XXIst ISTH Congress|
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