Clinical trial NCT04127682: Antibiotic Prescription for Children With Acute Upper Respiratory Tract Infections in Assiut District
Official title: Antibiotic Prescription for Children With Acute Upper Respiratory Tract Infections in Assiut District: An Exploratory Study.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Antibiotic Side Effect
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2019-10-15
Enrollment: 186
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Physicians dealing with cases of pediatrics' acute URIs at PHC units either urban or rural, insurance hospitals or Assiut university hospitals.

Brief summary: Antibiotics are one of the most commonly prescribed drugs in pediatric care all over the world. Over prescription of antibiotics is a major public health problem and the most important factor in the emergence of antibiotic resistance. It is important to study physicians' antibiotic prescribing behavior to understand its determinant and for further planning of appropriate interventions to optimize antibiotic prescription.

Detailed description: Antibiotics are one of the most commonly prescribed drugs in pediatric care all over the world. Over prescription of antibiotics is a major public health problem and the most important factor in the emergence of antibiotic resistance.

In Egypt, a recent study conducted in El-Minya governorate to investigate antibiotic use in PHC centres and in governmental hospitals, revealed that physician prescriptions of antibiotics for ARIs were extremely high as 82% of pediatric visits for ARIs resulted in an antibiotic prescription. Most of these infections are caused by viruses and do not require antibiotic treatment.

Numerous interventions to improve antibiotic prescribing practices have been reported from various countries with varying results. No single intervention appears to have superior efficacy, but combinations of interventions are typically more effective, and strategies that target health care professionals and/or patients (or parents of young children) have achieved success at reducing antibiotic prescriptions for ARIs.

Despite the emergence of antibiotic resistance and international efforts to reduce antibiotic use, prescription still high and inappropriate. Children are a vulnerable group and inappropriate antibiotic prescription may affect their health and may contribute to development of many diseases as allergies beside emergence of antibiotic resistance. Also, most of acute respiratory infections in children are viral infections and they receive antibiotic for it. So,, it is important to study physicians' antibiotic prescribing behavior to understand its determinant and for further planning of appropriate interventions to optimize antibiotic prescription.

Eligibility criteria: Inclusion criteria:

1. Physicians dealing with pediatric cases.
2. GPs, pediatrics, or otolaryngology (ENT) residents.

Exclusion criteria:

1. Physician who didn't work at outpatient clinics.
2. Physicians who are specialized and hold a degree.

Primary outcomes:
measure: Physicians knowledge of antibiotic resistance
timeFrame: 6 months
measure: Attitude and practice of physicians as regard antibiotic prescription in pediatric cases of acute upper respiratory tract infections.
timeFrame: 6 months
Secondary outcomes:
measure: Determinants of physicians' antibiotic prescribing behavior in cases of acute upper respiratory tract infection in children.
timeFrame: 6 months
Other outcomes:
Locations:
city: Assiut
country: Egypt
facility: Faculty of medicine- Assiut university
Study officials:
affiliation: Public Health Department, Faculty of Medicine, Assiut University
name: Mahmoud A Abd El Aty
role: STUDY_DIRECTOR
affiliation: Public Health Department, Faculty of Medicine, Assiut University
name: Sabra M Ahmed
role: STUDY_DIRECTOR
affiliation: Pediatrics department, Faculty of Medicine, Assiut University
name: Ghada O El-Sadafi
role: STUDY_DIRECTOR
affiliation: Public Health Department, Faculty of Medicine, Assiut University
name: Amira F El-Gazzar
role: STUDY_DIRECTOR
affiliation: Public Health Department, Faculty of Medicine, Assiut University
name: Mariam T Amin
role: PRINCIPAL_INVESTIGATOR
References:
citation: Tamma PD, Cosgrove SE. Let the games begin: the race to optimise antibiotic use. Lancet Infect Dis. 2014 Aug;14(8):667-668. doi: 10.1016/S1473-3099(14)70809-6. Epub 2014 Jul 9. No abstract available.
citation: Dooling KL, Kandeel A, Hicks LA, El-Shoubary W, Fawzi K, Kandeel Y, Etman A, Lohiniva AL, Talaat M. Understanding Antibiotic Use in Minya District, Egypt: Physician and Pharmacist Prescribing and the Factors Influencing Their Practices. Antibiotics (Basel). 2014 Jun 20;3(2):233-43. doi: 10.3390/antibiotics3020233.
citation: Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, Knight TK, Hay JW, Doctor JN. Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial. JAMA. 2016 Feb 9;315(6):562-70. doi: 10.1001/jama.2016.0275.
citation: Amin MT, Abd El Aty MA, Ahmed SM, Elsedfy GO, Hassanin ES, El-Gazzar AF. Over prescription of antibiotics in children with acute upper respiratory tract infections: A study on the knowledge, attitude and practices of non-specialized physicians in Egypt. PLoS One. 2022 Nov 3;17(11):e0277308. doi: 10.1371/journal.pone.0277308. eCollection 2022.