Consumption of antibiotics by children in Greece: a cross-sectional study

BACKGROUND: Greece is among the European countries with the highest consumption of antibiotics. OBJECTIVES: To study the rates and characteristics of consumption of antibiotics in the community by children in Greece. METHODS: Questionnaire-based study of parents of hospitalized children. RESULTS: A total of 549 children were studied; 247 (45%) received at least one course of antibiotics the previous year (mean number of antibiotic courses the past year: 1.9), including 427 (91.8%) following examination by a pediatrician, 6 (1.3%) following phone consultation, 2 (0.4%) following suggestion by a pharmacist and 2 (0.4%) as self-medication. Prevalent reasons for antibiotic consumption were acute otitis media (AOM) (27.3%), pharyngotonsillitiss (25.4%), and bronchitis (17.8%). Amoxicillin-clavulanate was the prevalent antibiotic for pharyngotonsillitis, urinary tract infection (UTI) and skin infection (30.5%, 35.7% and 36.4% of cases, respectively), amoxicillin for AOM and pneumonia (32.3% and 36.4% of cases, respectively), and clarithromycin for bronchitis (27.7%). We found 84.3%, 81.9%, 64.3%, 63.7%, and 50% of parents reporting treatment consisted with the national guidelines for AOM, pneumonia, UTI, skin infection, and pharyngotonsillitis, respectively. In the multivariate analysis, an age of 1–5 years and asthma were significantly associated with a higher probability for antibiotic consumption. CONCLUSIONS: Antibiotic consumption of children in Greece is mainly driven by pediatricians. Continuing medical education is expected to further improve antibiotic prescription practices by pediatricians.