A Clinical and Organizational Approach to Optimizing Antibiotic Therapy for Acute Respiratory Infections in Children in Outpatient Practice

Goal. To evaluate the effect of the algorithm for clinical assessment of the risk of hospitalization on the frequency of prescribing antibiotics to children with respiratory infection seeking primary medical care. Materials and methods. The study was conducted on the basis of the Children's Republican Clinical Hospital named after N.M.Kuraev. The study included children aged 0-9 years. The intervention included the use by doctors of a clinical algorithm focused on identifying risk groups and making decisions about the need for antibiotic therapy. The rates of prescribing amoxicillin and macrolides, as well as the frequency of hospitalizations, were compared. The data was analyzed according to the principle of intention to treat. Results. The frequency of antibiotic prescribing in the intervention group was 0.157 per 1,000 children versus 0.159 in the control group. The difference did not reach statistical significance (the ratio of indicators was 0.987; p=0.31). The frequency of hospitalizations also did not show significant differences. Conclusions. The use of an algorithm for clinical risk assessment in children with acute respiratory infections proved insufficient to significantly reduce antibiotic prescribing. Further research is needed aimed at behavioral optimization of clinical decisions in outpatient practice.