Impact of two interventions (C reactive protein point-of-care testing and education) on antibiotic prescribing for children with acute infections in primary care in Latvia: e-posters

Backgrounds: Antibiotics are the most commonly administered prescription drugs for children and around 90% are prescribed in primary care. However, most of acute infection episodes are of viral etiology and do not require specific treatment. The aim of this study is to explore whether implementation of C reactive protein (CRP) point-of-care tests (POCT) and doctor education reduce antibiotic prescribing for children with acute illnesses.

Methods:: Single-arm pre-post intervention study was conducted in Latvia between November 2019 and May 2021. 40 family physicians from various Latvian regions were asked to record data on pediatric patients aged 1 month up to 17 years who were consulted with acute infections with duration of symptoms less than 5 days. After 3 months period all family physicians received CRP POCT and educational course. Antibiotic prescribing rates were compared before and after the interventions carried out.

Results: During 18 months period 1517 patients were included (n=886 in pre-intervention group; n=631 in post-intervention group) with the median age 5.0 years in pre-intervention group and 4.0 years in postintervention group. The most common infections in both study groups were upper respiratory infections (76.2% (n=675) in pre-intervention group and 71.9% (n=454)) in post-intervention group) and lower respiratory infections (20.3% (n=180) in pre-intervention group and 21.1% (n=133) in post-intervention group). For 32.4% (n=287) of patients in pre-intervention group and 32.3% (n=204) patients in postintervention group antibiotics were prescribed and the difference was not statistically significant (p=0.98).

Conclusions/Learning Points: Our results showed that availability of CRP POCT and family physician education intervention didn’t significantly reduce antibiotic prescribing for children with acute infections. Other or additional methods to decrease inappropriate antibiotic prescribing should be considered.