Perfil de prescritores de prescrição de antimicrobianos nas infecções das vias aéreas superiores em pediatria

Abstract

Objective: To describe the profile of physicians that care for children in Brazilian public and private health systems, and to verify how antimicrobials for upper respiratory airway infections are prescribed. Methods: Physicians in some cities of the state of São Paulo (Southeast Brazil) received an explanatory letter by mail or at the Primary Health Care Units about the research and a form with questions concerning: time of graduation, medical residency, workload and workplace, how they update their medical knowledge, factors considered when prescribing antimicrobials, and clinical cases on upper respiratory infections. Personal information was related to the answers of the clinical cases. For statistical analysis, the Z and Tukey- Kramer tests were applied, being significant p<0.05. Results: The sample included 170 prescribers, out of whom 87% had medical residence in Pediatrics, 75% worked for the Public Health System, and 71% worked more than 40 hours per week. Physicians who graduated in the past ten years emphasized the pharmaceutical industry as a way of keeping themselves updated in comparison to the ones who had been graduated for more than 30 years; 33% of the public health system physicians cared for more than five patients per hour. Regarding clinical cases, the correct answers averaged 87%. Consulting medical entities as a way of continuous medical education was associated with correct answers, while using materials from the pharmaceutical industry was associated with the incorrect ones (p<0.05). There was a clear trend towards decreasing the quality of the prescription as the number of patients per hour increased. Conclusions: Efficient education and improvement of work load could reduce the prescription of antibiotics for upper airway infections in children.