Ph.d. avhandlinger finansiert av AMFF 2008 -

Respiratory tract infections and prescription drugs in mother and child. A study from Norwegian general practice. 2.4.19

Guro Haugen Fossum: Which upper airway infections should be treated with
antibiotics in primary health care - and which type of antibiotics should be used?

Hovedveileder: Morten Lindbæk; Medveileder: Kari Kværner
Prøveforelesning og disputas 2.april 2019

5. juni 2020

Sammendrag av avhandlingen:
Most antibiotics sold in Norway are prescribed in general practice, and treatments for respiratory tract infections (RTIs) represents a majority of these. Overall consumption of antibiotics has shown a decreasing trend the last years, and stewardships are now focusing more on appropriate use.
Aims of this thesis were to explore the GPs’ antibiotic prescription rates and patterns when treating children and pregnant women with RTIs, and to investigate a possible association between prenatal antibiotic exposure and the use of antibiotics and antiasthmatics in children younger than one year. We performed three observational studies, using GP and RTI consultation data from a local database, pregnancy data from the Medical Birth Registry of Norway and prescription data from the Norwegian Prescription database.
The average antibiotic prescription rate for RTI episodes with children aged 0-6 years was 26.2%. The corresponding rates in women were 25.9% (pregnant) and 34.2% (time before/after pregnancy). The proportion non-Penicillin V prescribed for children 0-6 years was 58%. Non-Penicillin V proportions for episodes with pregnant and non-pregnant women were 35.9% and 44.7%, respectively. The GPs with high antibiotic prescription rates had a higher proportion of non-Penicillin V prescriptions.
There was a significant association between dispensed antibiotics by mothers, independent of the pregnancy period, and dispensed antibiotics and antiasthmatics in children the first year of life. When assessing exposure in utero, the strongest association was observed between dispensed antibiotics in the third trimester and both antibiotic and antiasthmatic dispensions in children younger than one year.
Overall, the antibiotic prescription rates were low, but with a high proportion of non-penicillin V prescribed to children. The association between maternal antibiotic use and the use of antibiotics and antiasthmatics in small children needs to be explored further.