期刊
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
卷 25, 期 6, 页码 810-818出版社
AMER BOARD FAMILY MEDICINE
DOI: 10.3122/jabfm.2012.06.110310
关键词
Antibiotics; Child; Family in Family Medicine; Family Medicine; Fever; Infectious Diseases; Pediatrics; Primary Health Care
资金
- Netherlands Organisation for Health Research and Development (ZonMw) [42000012]
Background: Fever is common in children and often self-limiting, nevertheless antibiotics are frequently prescribed. We determined how often antibiotics were prescribed in children presenting with fever at a family physicians' out-of-hours service and established the children's signs and symptoms related to antibiotic prescriptions. Patients: Children aged 3 months to 6 years with fever as the main reason for contact. Results: Of the 443 included children, 322 children had a face-to-face contact at the out-of-hours service. Of these, 117 (36.3%) were prescribed antibiotics, that is, 26.5% of the total study population. Concerned parents (OR, 2.02; 95% CI, 1.06-3.58), ill appearance (3.26; 1.30-8.20), earache resulting in altered behavioral or sleeping patterns (2.59; 1.06-6.30), signs of throat infection (2.37; 1.35-4.15), and decreased urine production (2.00; 1.17-3.41) were positively associated with antibiotic prescription. A negative association was found for age 3 to 6 months (0.17; 0.03-0.74) and temperature (0.52; 0.37-0.71). Conclusions: Antibiotics were prescribed in 1 out of 4 febrile children whose parents contacted the out-of-hours service. Items associated with antibiotic prescription provide insight into the family physicians' decision-making process when assessing children with fever. These can be used as targets for strategies to diminish antibiotic prescription. (J Am Board Fam Med 2012;25:810-818.)
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