Antibiotic use and antimicrobial resistance in school children

Uvod: Neracionalna uporaba antibiotika je zasigurno složen problem kojem doprinosi više čimbenika, ali i jedan od glavnih pokretača za pojavu i širenje rezistencije bakterija na antibiotike. Metode: U prospektivnom istraživanju obrađeni su obrisci ždrijela i nazofarinksa 450 djece školske dobi, 6-15 godina, Grada Rijeke i okolice. Dva presječna istraživanja su provedena pomoću strukturiranih upitnika o znanju, stavovima i praksi o uporabi antibiotika na 1000 roditelja djece osnovnih škola i 230 liječnika dentalne medicine Primorsko-goranske županije, Hrvatska. Rezultati: Izloženost antibioticima u djece školske dobi u prethodnih šest mjeseci je bila povezana s pojavom bakterija rezistentnih na antibiotike. Uporaba uskospektralnih penicilina je bila rjeđa nego uporaba amoksicilina (26% školska djeca, 33.1% liječnici dentalne medicine) i amoksicilina s klavulanskom kiselinom (26% školska djeca, 65% liječnici dentalne medicine). Roditelji i liječnici dentalne medicine su imali visoku svjesnost o rezistenciji bakterija na antibiotike. Zaključci: Uporaba antibiotika je povezana s višom stopom rezistencije u respiratornih patogena. Sociodemografske karakteristike roditelja nisu utjecale na uporabu antibiotika. Iako liječnici dentalne medicine posjeduju visoku svjesnost o rezistenciji bakterija na antibiotike, i dalje postoji prevelika uporaba antibiotika, naročito širokospektralnih te treba povećati osobnu odgovornost za racionalnu uporabu antibiotika.Introduction: Irrational antibiotic use is certainly complex and multifactorial problem, but also one of the major drivers for the emergence and spread of antimicrobial resistance. Methods: In prospective study throat and nasopharyngeal swabs from 450 school children, 6-15 years of age, from the city of Rijeka and the surrounding area, were processed. Two cross-sectional studies based on a structured questionnaire about knowledge, attitudes and practice regarding antibiotic use, that were given to 1000 parents of children attending elementary schools and 230 dental practitioners in outpatient settings of Primorsko-Goranska County, Croatia. Results: Antibiotic exposure in school children in the previous six months was associated with the carriage of antibiotic-resistant bacteria. The use of narrow spectrum penicillins was less common than the use of amoxicillin (26% school children, 33.1% dental practitioners) and amoxicillin with clavulanic acid (26% school children, 65% dental practitioners). Parents and dental practitioners had a high awareness of antimicrobial resistance. Conclusions: Antibiotic use is linked with higher resistance rates of respiratory tract pathogens. Parents' background did not influence the frequency of antibiotic use. Although there is a high level of antimicrobial resistance awareness among dental practitioners, there is still too much overuse of antibiotics, especially broad spectrum, and personal responsibility for rational antibiotic use should be increased