Introduction:

Respiratory infections are the most frequent presenting complaint and reason for prescription of antibiotherapy in paediatric care. Antibiotic resistance is a public health problem. Objective: to assess antibiotic prescription practices in the management of paediatric respiratory illness throughout Spain.

Material and methods:

We conducted a survey of Spanish paediatricians distributing a questionnaire by email. The statistical analysis was performed with the software SPSS version 20.0.

Results:

We received 362 responses. We found that 53.1% of respondents managed 25-35 patients daily. The mean number of correct answers was 18.8 out of 23. In the case of acute otitis media, respondents determined the indication and duration of antibiotherapy based on different criteria and in variable percentages; 98.6% used amoxicillin, and 97.2% prescribed it at correct doses. In the case of pharyngitis, 79.1% ordered microbiological tests, 50.8% prescribed amoxicillin and 48.6% penicillin, and 84% prescribed treatment for 10 days. When it came to respiratory illnesses of viral aetiology (bronchospasm, common cold and bronchiolitis), more than 90% did not prescribe antibiotics, although the presence of high fever or green nasal discharge was associated with more frequent prescription. In the case of typical pneumonia, up to 59.6% did not order a chest radiograph, 94.1% prescribed amoxicillin, and 68.3% prescribed treatment courses lasting 7 days. For atypical pneumonia, 97.8% prescribed macrolides. We found a statistically significant association between the years of experience and both the score in the questionnaire and the use of chest radiography; between the speciality of the clinician and the questionnaire score, and between physician workload and the ordering of microbiological tests in cases of pharyngitis.

Conclusions:

We found mistakes in the use of antibiotherapy in paediatric care. Strategies need to be developed to educate the population and health care providers to promote the rational use of antibiotics.

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