Keywords: antibiotic prescription, early Childhood, primary care setting
Introduction:
In the early years of life, the majority of respiratory infections are of viral etiology and often treated with antibiotics (Ab). The objective of PURAPI program was to evaluate the effectiveness of an intervention on the appropriate use of Ab for upper respiratory tract infections in children under three years of age, after being implemented in our Regional Health Service (1.500.000 inhabitants, 9 Health Area, 60 Health Centers) in 2015.
Method:
In 2015 a multidisciplinary working group was established, comprising pediatricians, pharmacists, nurses and anthropologists. The aim was to analyze Ab consumption and designing the PURAPI program. A qualitative methodology was carried out so as to identify barriers, needs, and facilitating factors influencing antibiotic prescription in the pediatric population. Eight indicators were defined to monitor the program, with monitoring conducted on an annual basis.
Results:
DDD: defined daily doses per 1000 inhabitants per year in our Region.
2015: 19,95; 2017: 17,77; 2018: 11,14; 2019: 10,25; 2020: 5,24; 2022: 6,59; 2022: 8,35; 2023: 9,23
A significant decrease in Ab consumption in the pediatric population has been observed, reaching a reduction of 49.40% during the period 2015–2023. The most substantial reduction occurred in the years 2021–2022, coinciding with the pandemic period.
Conclusions:
The implementation of PURAPI Program has successfully reduced antibiotic consumption in children under three years of age. Additionally, monitoring the evolution of Ab use across all health areas has made it possible to identify those primary healthcare centers where interventions should be implemented. Such interventions could help reduce Ab prescription in those health centers exhibiting a higher DDD.
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