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Committee Urges Caution With Antibiotics for Children

New guidelines stress stringent diagnosis (November 18)

A clinical report from the American Academy of Pediatrics (AAP), in collaboration with the Centers for Disease Control and Prevention (CDC), offers updated guidance on treating upper respiratory tract infections (URTIs) in children, with the goal of reducing unnecessary prescriptions of antibiotics.

The report, published online in Pediatrics, advises physicians to use stringent diagnostic criteria to distinguish between viral and bacterial infections. The report focuses on three of the most common URTIs: ear infections, sinus infections, and strep throat.

According to the AAP, studies have shown that as many as 10 million antibiotic prescriptions are written each year for infections they are unlikely to help. Recent evidence shows that prescriptions for broad-spectrum antibiotics have increased, even when no antibiotics are needed or when narrow-spectrum antibiotics would work. Overuse of antibiotics contributes to antibiotic resistance, making infections more difficult to treat.

Symptoms of the common cold, which is viral in nature, often persist for 10 days. Physicians treating such illnesses should focus on relieving symptoms and not prescribe antibiotics, the AAP says.

Earlier in 2013, the academy issued two new sets of clinical practice guidelines on acute otitis media and bacterial sinusitis, which include specific criteria to help physicians make an accurate diagnosis and to determine when antibiotics are needed. The key recommendations of those guidelines are included in the new clinical report, which also adds guidance on diagnosing and treating strep throat.

The judicious antibiotic principles outlined by the AAP can be applied broadly to antibiotic use in general. They include using stringent diagnostic criteria, weighing the benefits and harms of antibiotics, and choosing the appropriate dose of antibiotic for the shortest duration required.

“This is an important resource that provides guidance for clinicians, and will help in communication with families to make the best use of antibiotics,” said lead author Mary Anne Jackson, MD, FAAP. “Physicians and parents are increasingly aware of the risk of antibiotics and the impact on growing antibiotic resistance rates.”

Source: AAP; November 18, 2013.

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