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Master Thesis

Évaluation de l’utilisation des corticostéroïdes inhalés par les médecins généralistes de la Gironde au cours des manifestations irritatives de l’appareil respiratoire chez les enfants de 0 à 6 ans

Abstract : While in children, inhaled corticoteroids (ICS) are only recommanded to treat uncontrolled asthma, I’ve sometimes observed, in my practice, an intermittent use of these ICS by general practitionners during irritative respiratory tract infections. An opinion survey on practices was conducted by telephone among randomised Gironde’s general practitionners (GP). The primary objective was to assess their prescription of short courses of ICS in O-6 year-old children. In our survey, 87% of GP reported to have previously ordered children short courses of ICS. Almost a third of them declare that this was a frequent prescription. The clinical situations indicated by the most doctors as situations that could lead to this prescription are : exacerbation of asthma, bronchiolitis, wheezing, prolonged cough, cough associated with atopy, and emetic or noctural cough. We analysed a few hypothesis in respect of this misuse’s origins. Obtaining a university degree in pediatrics was the only caracteristic significantly associated to a lower use of ICS short courses (p=0,02). An efficiency on cough estimated by few doctors, or parental pressure felt by others appear to be potentiel levers of this off-label use of ICS. Moreover, adherence to recommendations and prescription of drug-free therapies sometimes seem to be difficult. Besides the recent contraindication of anticough medicines and mucolytics in infants was, for 23% of GP, a contributing factor to have an intermittent use of ICS as an antitussive medication.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01142709
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, April 15, 2015 - 5:44:55 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:38 PM
Long-term archiving on: : Tuesday, April 18, 2017 - 9:12:20 PM

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Vanessa Piat. Évaluation de l’utilisation des corticostéroïdes inhalés par les médecins généralistes de la Gironde au cours des manifestations irritatives de l’appareil respiratoire chez les enfants de 0 à 6 ans. Médecine humaine et pathologie. 2015. ⟨dumas-01142709⟩

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