# Implementation of a Multifaceted Program to Improve the Rational Use of Antibiotics in Children under 3 Years of Age in Primary Care

## TL;DR

A program in Spain successfully reduced antibiotic use in young children with common colds and ear infections, but results varied across regions.

## Contribution

A multifaceted program reduced antibiotic prescriptions for children under 3 with upper respiratory infections in primary care.

## Key findings

- Antibiotic prescriptions for children under 3 dropped from 45.7% to 10.25 DHD after the program.
- The program achieved a 48% overall reduction in antibiotic use compared to 2015.
- Health areas showed inconsistent reductions in antibiotic consumption.

## Abstract

A multifaceted, participatory, open program based on a qualitative and quantitative approach was developed in the Region of Murcia (Spain) aimed to reduce antibiotic use in children under 3 years of age diagnosed with upper respiratory tract infections (acute otitis media, pharyngitis, and common cold). Antibiotic consumption was measured using the defined daily dose per 1000 inhabitants per day (DHD). Pre-intervention data showed a prevalence of antibiotic prescriptions in the primary care setting of 45.7% and a DHD of 19.05. In 2019, after the first year of implementation of the program, antibiotic consumption was 10.25 DHD with an overall decrease of 48% as compared with 2015. Although antibiotic consumption decreased in all health areas, there was a large variability in the magnitude of decreases across health areas (e.g., 12.97 vs. 4.77 DHD). The intervention program was effective in reducing the use of antibiotics in children under 3 years of age with common upper respiratory diseases, but reductions in antibiotic consumption were not consistent among all health areas involved.