Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care
Abstract
:1. Introduction
2. Results
2.1. Antibiotic Consumption in the Pilot Phase
2.2. Antibiotic Consumption after the Implementation of the PURAPI Program
3. Discussion
4. Materials and Methods
4.1. Background and Description of the Intervention (PURAPI Program)
4.2. Implementation of the PURAPI Program
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- Integration of monitoring indicators of the PURAPI program into the Business Intelligence Portal of the Health Service of the Region of Murcia. This platform allows all healthcare professionals to access information on the consumption of medicines.
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- Appointment of a reference pediatrician in each health center, who was responsible for communicating information to other colleagues about the interventions carried out under the PURAPI program.
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- Integration of algorithms for the most prevalent childhood diseases into Primary Care Management Programs (OMI-AP) and Primary Care Emergency Services (OMI-SURE) as tools to aid antibiotic prescription.
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- Development of continuing training programs on the rational use of antibiotics.
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- Implementation of rapid diagnostic methods in primary care consultations (Strep A test).
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- Development of seminars on the appropriate use of antibiotics in clinical practice, management of fear and uncertainty in prescribing practice.
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- Use of deferred (delayed) prescribing.
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- Creation of Guides for families on the most common childhood illnesses.
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- Conducting workshops on the appropriate use of antibiotics in managing prevalent infant diseases, such as bronchiolitis, fever, common cold, and acute gastroenteritis. The content of these workshops is compiled in the “Guides for families of diseases in childhood” (https://www.escueladesaludmurcia.es/escuelasalud/cuidarse/pediatria/guiasanticipatorias.jsf, accessed on 30 October 2020).
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- Development of educational materials (posters and informative brochures) aimed at the general population and distributed in primary healthcare centers, hospitals, and all community pharmacies. These materials are available on the health website of the Region of Murcia (program of the first 1000 days of life) (https://www.murciasalud.es/en/programa-primeros-1000-dias-de-vida, accessed on 7 November 2022) and the website of the Health School of the Region of Murcia (https://www.escueladesaludmurcia.es/escuelasalud/cuidarse/pediatria/guiasanticipatorias.jsf, accessed on 30 October 2020).
4.3. Qualitative and Quantitative Assessments of Antibiotic Consumption
4.4. Information on Consumption of Antibiotics
4.5. Measurement and Indicators of Consumption
4.6. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ÁREA | MIN-2015 | MAX-2015 | MIN-2019 | MAX-2019 |
---|---|---|---|---|
I | 6.56 | 31.95 | 5.51 | 16.86 |
II | 7.2 | 24.86 | 4.19 | 21.61 |
III | 11.08 | 33.53 | 7 | 16.83 |
IV | 13.52 | 50.44 | 5.96 | 28.96 |
V | 9.52 | 18.45 | 3.42 | 10.09 |
VI | 10.3 | 18.95 | 4.01 | 15.82 |
VII | 10.06 | 25.98 | 6.43 | 15.53 |
VIII | 17.51 | 26.9 | 10.51 | 15.54 |
IX | 9.84 | 23.94 | 9.04 | 15.82 |
Variable | Year | Total Healthcare Areas | Mean ± SD | Between-Years p Value * | Between-Areas p Value † |
---|---|---|---|---|---|
DHD | 2015 | 9 | 19.05 ± 4.04 | 0.001 | 1 |
2017 | 9 | 18.61 ± 3.23 | |||
2018 | 9 | 11.48 ± 2.06 | |||
2019 | 9 | 10.49 ± 1.95 |
Variable | Years | Mean Differences (SD) | p Value | 95% Confidence Interval | |
---|---|---|---|---|---|
DHD | 2015 | 2017 | 0.44 (1.39) | 0.75 | −2.40 to 3.28 |
2018 | 7.57 (1.39) | <0.001 | 4.74 to 10.41 | ||
2019 | 8.56 (1.39) | <0.001 | 5.73 to 11.40 |
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Alfayate-Miguélez, S.; Martín-Ayala, G.; Jiménez-Guillén, C.; Alcaraz-Quiñonero, M.; Delicado, R.H.; Arnau-Sánchez, J. Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care. Antibiotics 2024, 13, 572. https://doi.org/10.3390/antibiotics13070572
Alfayate-Miguélez S, Martín-Ayala G, Jiménez-Guillén C, Alcaraz-Quiñonero M, Delicado RH, Arnau-Sánchez J. Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care. Antibiotics. 2024; 13(7):572. https://doi.org/10.3390/antibiotics13070572
Chicago/Turabian StyleAlfayate-Miguélez, Santiago, Gema Martín-Ayala, Casimiro Jiménez-Guillén, Manuel Alcaraz-Quiñonero, Rafael Herrero Delicado, and José Arnau-Sánchez. 2024. "Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care" Antibiotics 13, no. 7: 572. https://doi.org/10.3390/antibiotics13070572