[Unscheduled pediatrician office visits: A national survey]

Paediatric antibiotic prescriptions in primary care in the Alpes-Maritimes area of southeastern France between 2008 and 2013

France has remained among the top five European countries for ambulatory antibiotic consumption since such monitoring began in 1998. Young children are major antibiotic consumers, in spite of the viral origin of most infections in this population. Recommendations were updated in 2011 to limit prescriptions. In order to assess their impact, diagnoses and prescriptions were compared in a population of children attending daycare centres in southeastern France in 2008 and 2012. Trends in the reimbursement of paediatric antibiotic prescriptions by the national health insurance (NHI) for the whole area were also studied. Distribution of diagnoses accounting for antibiotic treatment and type of antibiotic prescribed over the previous 3 months to children below 4 years of age attending daycare centres in the Alpes-Maritimes area in southeastern France were compared between 2008 and 2012 prior to and following the availability of these new recommendations. Trends in reimbursed ambulatory antibiotic prescriptions by general practitioners and paediatricians in the area were studied for this age group from 2008 to 2012 and in 2013. The majority of recorded diagnoses concerned upper respiratory tract infections (URTI). Inappropriate antibiotic prescription persisted for colds and bronchitis in similar proportions during both surveys. Improvement in the choice of antibiotic with fewer prescriptions for third-generation cephalosporins was observed both in daycare centres and according to NHI data; however, this was mainly recorded among paediatricians. The management of paediatric URTI still needs improvement, pointing to the need to investigate and adequately address the reasons for inappropriate antibiotic prescription.