Duration of antibiotic therapy among paediatricians: A national survey of current clinical practice in Spain

Objectives: Appropriate duration of antibiotic treatment is a key principle to reduce the emergence of bacterial resistance and antibiotic harm. The aim of this study was to document current clinical practice among Spanish paediatricians in terms of the duration of antibiotic therapy in both inpatient and outpa-tient settings, mapping the difference between practice and guidelines, and thus identifying opportunities to improve practice.Methods: A national exploratory work survey was distributed in 2020 as a questionnaire about seven main infectious syndromes in children: genitourinary; skin and soft tissue; osteoarticular; ear, nose and throat; pneumonia; central nervous system; and bacteraemia. The answers were contrasted with current recommendations regarding the duration of antibiotic therapy. Demographic analysis was also performed.Results: The survey was completed by 992 paediatricians in Spain, representing 9.5% of paediatri-cians working in the Spanish national health system. Hospital care clinicians accounted for 42.7% (6662/15590) of responses. The antibiotic duration used in practice was longer than recommended in 40.8% (6359/15590) of responses, and shorter than recommended in 16% (1705/10654) of responses. Only 25% (249/992) and 23% (229/992) of respondents indicated that they would prescribe antibiotics for the recommended treatment duration for lower urinary tract infection and community-acquired pneumo-nia (AI evidence). Among severe hospital-managed infections, a tendency towards longer courses of an-tibiotics was found for non-complicated meningococcal infections and non-complicated pneumococcal, Gram-negative and S. aureus bacteraemia.Conclusions: A noteworthy tendency towards prescribing antibiotics for longer than recommended among paediatricians was evidenced in this nationwide study, highlighting a wide range of opportunities for potential improvement.(c) 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.

Automated summary

The aim of this study was to examine the duration of antibiotic therapy among Spanish paediatricians and compare it with guidelines. The survey showed that 40.8% of respondents used antibiotics for longer than recommended, while 16% used them for shorter durations. This study revealed a notable tendency among paediatricians to prescribe antibiotics for longer than recommended, highlighting various opportunities for improvement.