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Master Thesis

Prescriptions antibiotiques des médecins généralistes du Béarn dans les infections respiratoires hautes de l’enfant : conformité par rapport aux recommandations

Abstract : Background: the high antibiotic consumption and the emergence of bacterial resistance are a major public health issue. Child upper respiratory tract infections represent the first cause of consultation for the general practitioners (GPs) in winter and are source of very numerous antibiotic prescriptions. Objective: To analyze the GPs compliance with antibiotic prescriptions in child upper respiratory tract infections compared to the last recommendations of 2011. Methodology: prospective observational survey conducted in Béarn, including children from 3 months to 15 years old, consulting a GP for upper respiratory tract infections. GPs prescriptions, epidemiological characteristics and knowledge of antimicrobial ecology were studied using a double questionnaire. Results: 295 children were included by 37 GPs. Within these prescriptions, 64.4% were compliance with recommendations. The main causes of non compliance were a wrongly prescribed treatment (55%) or an no indication for antibiotic therapy (40%). The prescription rate of amoxicillin, first prescribed antibiotic (45.8%), was still insufficient regarding recommendations. There was an over-prescription of 3rd generation cephalosporins (26.2%) and amoxicillin / clavulanic acid (13.1%). We did not find any significant factor favoring the prescription’s compliance, except for the male sex of the prescriber. Antigen detection tests were achieved in 60.8% of acute pharyngitidis in children over 3 years of age. Conclusion: the recommendations are not satisfactorily applied by GPs generating antibiotics overconsumption and an important prescription of broad-spectrum antibiotics favoring bacterial resistance. Medical training, patient education and national health policies could improve these practices.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02499540
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Laure Bariteau. Prescriptions antibiotiques des médecins généralistes du Béarn dans les infections respiratoires hautes de l’enfant : conformité par rapport aux recommandations. Médecine humaine et pathologie. 2019. ⟨dumas-02499540⟩

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