Non-adherence to antibiotic prescription guidelines in treating urinary tract infection of children: A population-based study in Taiwan

Chu C. Chen, Li C. Wu, Chung Y. Li, Chih K. Liu, Lin C. Woung, Ming C. Ko

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: Inappropriate use of antibiotics may increase antibiotic resistance and health care service load. Few studies have been conducted to investigate physician non-adherence to antibiotic prescription guidelines for treating urinary tract infections (UTIs) in child patients. This study aimed to examine the rates of and factors associated with non-adherence to antibiotic prescription guidelines for treating uncomplicated UTIs in child patients. Methods: This is a cross-sectional study in which a random sample of 8921 children who received antibiotics prescription for UTIs (ICD-9-CM: 590.1, 595.0, 595.9 or 599.0) at age 17 years or less, between 2000 and 2007, were analysed. Data analysed were retrieved from Taiwan's National Health Insurance database. Non-adherence was determined by antibiotic prescription not recommended by the Infectious Disease Society of Taiwan. Multivariate logistic regression model was employed to assess the potential predictors for non-adherence, including various characteristics of patients, physicians and medical institutions. Results: The overall non-adherence rate was estimated at 20.05%. Older patients, older physicians and physicians from community clinics were associated with higher rates of non-adherence. Compared with pediatricians who had the lowest rate (13.15%) of non-adherence, certain specialties were found to have significantly elevated adjusted odds ratio (AOR) of non-adherence, with the highest one noted for gynecologists (35.11%, AOR = 2.29, 95% confidence interval: 1.89-2.77). We also observed that the most frequently prescribed antibiotics not recommended on guidelines varied with physician specialty. Conclusions: Special attention should be concentrated on older physicians, gynecologists and physicians who practiced at community clinics to reduce non-adherence of antibiotic prescription for treating UTIs in child patients.

Original languageEnglish
Pages (from-to)1030-1035
Number of pages6
JournalJournal of Evaluation in Clinical Practice
Volume17
Issue number6
DOIs
Publication statusPublished - 2011 Dec

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

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