Abstract
BACKGROUND: There is a lack of evidence documenting the impact of optimized antibiotic use on the rates of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae (PNSP) in children. This study evaluates the effect of community-based intervention strategies on the prevalence of pnsp colonization. METHODS: A controlled, population-based pharmacoepidemiological trial was conducted from January through May 2000. Three French geographic areas were selected on the basis of demographic similarities. Two intervention strategies were implemented: (1) reduced antibiotic use, which was achieved by not prescribing antibiotics for presumed viral respiratory tract infections (the prescription-reduction group); and (2) better adaptation of dose and duration (the dose/duration group). A control group received no intervention. The target population was children aged 3-6 years who were attending kindergarten. Oropharyngeal pneumococcus colonization and antibiotic use were monitored throughout the 5-month study. RESULTS: The prescription-reduction, dose/duration, and control groups included 601, 483, and 405 children, respectively. The interventions induced significantly larger decreases in antibiotic use in the prescription-reduction group (-18.8\%) and dose/duration group (-17.1\%) than in the control group (-3.8\%), and the rates of PNSP colonization were initially similar for the 3 groups (52.5\%, 55.1\%, and 50.0\%, respectively). At the end of the 5-month study, the rates of PNSP colonization were 34.5\% for the prescription-reduction group (P=.05) and 44.3\% for the dose/duration group (P=.8), compared with 46.2\% for the control group. CONCLUSIONS: Intensive educational strategies aimed at optimizing antibiotic use can significantly reduce the rate of PNSP colonization in areas with high resistance rates.
- administration
- agents,
- carrier
- child,
- community
- drug
- factors
- female,
- france,
- g,
- health
- humans,
- infections,
- male,
- patterns,
- penicillin
- physician's
- pneumococcal
- pneumoniae,
- practice
- preschool,
- prescriptions,
- resistance,
- routes,
- schedule,
- services,
- state,
- streptococcus
- time
- utilization,
- {anti-bacterial}
Users
Please
log in to take part in the discussion (add own reviews or comments).