Overprescribing of antibiotics to children in rural Vietnam

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100 children (aged 1–6 y), who received an antibiotic prescription after health examination in the Bavi health care system (79 children at a district hospital, 21 at a community health centre) were analysed regarding antibiotics prescribed in relation to serum C-reactive protein (CRP). A control group consisted of 35 healthy children. Children who had been treated with antibiotics within 1 week prior to the study were excluded in the community health centre and control groups. Capillary blood samples were collected and the serum CRP concentration was analysed. A questionnaire interview with the carers was performed. Elevated CRP concentrations (>10 mg/l) were detected in 17(17%) of the study population, and only 2 had a CRP level above 25 mg/l, one 36 mg/l and the other 140 mg/l. In the control group, none of the children had elevated CRP. The most common diagnoses were acute respiratory tract infection (ARI, 55%), asthma (7%), tonsillitis (4%), and diarrhoea (4%). The average number of drugs per patient was 3.1, and 77% received vitamins and 15% corticosteroids in combination with antibiotics. A majority of children who received an antibiotic prescription based on clinical examination did not have an elevated CRP and overprescribing of antibiotics was thus indicated.

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