Inappropriate antibiotic prescription to children with acute respiratory infection in Brazil.

  • 1 January 2003
    • journal article
    • research article
    • Vol. 40  (1) , 7-12
Abstract
To determine the rate of inappropriate antibiotic prescription and to describe the types of antibiotics prescribed by health workers to children with acute respiratory infection (ARI). Cross-sectional survey conducted in 6 state capitals of Brazil. A representative sample of facilities was selected in each state using a cluster sampling method based on the mean number of visits of children less than 5 years of age. In each facility, consultations were observed and children were reassessed following standard guidelines. Health worker s diagnosis and treatment were compared with a gold standard and inappropriate antibiotic prescriptions noted. 1565 children with ARI from 156 health facilities (73% health centers) were included in study. Most children had a common cold (77.5%). Antibiotics were inappropriately prescribed in 9.2% (95% CI: 7.8, 10.7) of ARI cases (range: 2.8% to 25%). Most frequently prescribed antibiotics were those recommended by the ARI Program. Seventy-six percent of health workers explained to guardians how to use antibiotics at home and 3.9% demonstrated the first dose. Antibiotics were available in 84% of health facilities. Inappropriate prescription of antibiotics varied geographically in Brazil. More training and supervision is needed to decrease it.

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