| Title: |
Variation in antibiotic prescription rates in febrile children presenting to emergency departments across Europe (MOFICHE): A multicentre observational study. |
| Authors: |
Hagedoorn, Nienke N; Borensztajn, Dorine M; Nijman, Ruud; Balode, Anda; von Both, Ulrich; Carrol, Enitan D; Eleftheriou, Irini; Emonts, Marieke; van der Flier, Michiel; de Groot, Ronald; Herberg, Jethro; Kohlmaier, Benno; Lim, Emma; Maconochie, Ian; Martinon-Torres, Federico; Nieboer, Daan; Pokorn, Marko; Strle, Franc; Tsolia, Maria; Yeung, Shunmay; Zavadska, Dace; Zenz, Werner; Vermont, Clementien; Levin, Michael; Moll, Henriëtte A; PERFORM consortium |
| Publisher Information: |
PUBLIC LIBRARY SCIENCE |
| Publication Year: |
2020 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
BACKGROUND: The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or bacterial disease is essential for the development and implementation of interventions to optimise antibiotic use. As part of the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union) project, the MOFICHE (Management and Outcome of Fever in Children in Europe) study aims to investigate variation and appropriateness of antibiotic prescription in febrile children visiting EDs in Europe. METHODS AND FINDINGS: Between January 2017 and April 2018, data were prospectively collected on febrile children aged 0-18 years presenting to 12 EDs in 8 European countries (Austria, Germany, Greece, Latvia, the Netherlands [n = 3], Spain, Slovenia, United Kingdom [n = 3]). These EDs were based in university hospitals (n = 9) or large teaching hospitals (n = 3). Main outcomes were (1) antibiotic prescription rate; (2) the proportion of antibiotics that were broad-spectrum antibiotics; (3) the proportion of antibiotics of appropriate indication (presumed bacterial), inappropriate indication (presumed viral), or inconclusive indication (unknown bacterial/viral or other); (4) the proportion of oral antibiotics of inappropriate duration; and (5) the proportion of antibiotics that were guideline-concordant in uncomplicated urinary and upper and lower respiratory tract infections (RTIs). We determined variation of antibiotic prescription and broad-spectrum prescription by calculating standardised prescription rates using multilevel logistic regression and adjusted for general characteristics (e.g., age, sex, comorbidity, referral), disease severity (e.g., triage level, fever duration, ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
1549-1277 |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4657904/1/Variation%20in%20antibiotic%20prescription%20rates%20in%20febrile%20children%20presenting%20to%20emergency%20departments%20across%20Europe%20%28MOFICHE%29%20A.pdf; Hagedoorn, Nienke NORCID logo; Borensztajn, Dorine MORCID logo; Nijman, RuudORCID logo; Balode, Anda; von Both, UlrichORCID logo; Carrol, Enitan DORCID logo; Eleftheriou, IriniORCID logo; Emonts, MariekeORCID logo; van der Flier, MichielORCID logo; de Groot, Ronald; +16 more.Herberg, JethroORCID logo; Kohlmaier, BennoORCID logo; Lim, Emma; Maconochie, IanORCID logo; Martinon-Torres, FedericoORCID logo; Nieboer, DaanORCID logo; Pokorn, MarkoORCID logo; Strle, FrancORCID logo; Tsolia, Maria; Yeung, Shunmay ORCID logo; Zavadska, DaceORCID logo; Zenz, Werner; Vermont, Clementien; Levin, MichaelORCID logo; Moll, Henriëtte AORCID logo; and PERFORM consortium (2020) Variation in antibiotic prescription rates in febrile children presenting to emergency departments across Europe (MOFICHE): A multicentre observational study. PLOS MEDICINE, 17 (8). e1003208-. ISSN 1549-1277 DOI:10.1371/journal.pmed.1003208 |
| DOI: |
10.1371/journal.pmed.1003208 |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4657904/; https://researchonline.lshtm.ac.uk/id/eprint/4657904/1/Variation%20in%20antibiotic%20prescription%20rates%20in%20febrile%20children%20presenting%20to%20emergency%20departments%20across%20Europe%20%28MOFICHE%29%20A.pdf; https://doi.org/10.1371/journal.pmed.1003208 |
| Rights: |
cc_by |
| Accession Number: |
edsbas.A66627FB |
| Database: |
BASE |