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Pediatricians’ Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan
Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current stu...
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Published in: | Healthcare (Basel) 2021-06, Vol.9 (6), p.701 |
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creator | Shakeel, Sadia Iffat, Wajiha Qamar, Ambreen Ghuman, Faiza Yamin, Rabia Ahmad, Nausheen Ishaq, Saqib Muhammad Gajdács, Márió Patel, Isha Jamshed, Shazia |
description | Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children |
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Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.</description><identifier>ISSN: 2227-9032</identifier><identifier>EISSN: 2227-9032</identifier><identifier>DOI: 10.3390/healthcare9060701</identifier><identifier>PMID: 34207813</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Antibiotics ; Children & youth ; clinical management guidelines ; Clinical medicine ; community-acquired pneumonia ; Drug resistance ; Family physicians ; Health facilities ; Hospitals ; Infectious diseases ; Intensive care ; lower respiratory tract infections ; Mortality ; Pakistan ; Pathogens ; pediatricians ; Pediatrics ; Physicians ; Pneumonia ; Questionnaires</subject><ispartof>Healthcare (Basel), 2021-06, Vol.9 (6), p.701</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-27118e494bc260f2728a6e5cb6ad92de48aa6abfc26edc8885bc17017366c8ff3</citedby><cites>FETCH-LOGICAL-c470t-27118e494bc260f2728a6e5cb6ad92de48aa6abfc26edc8885bc17017366c8ff3</cites><orcidid>0000-0003-4941-3124 ; 0000-0003-1270-0365</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2544835520/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2544835520?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Shakeel, Sadia</creatorcontrib><creatorcontrib>Iffat, Wajiha</creatorcontrib><creatorcontrib>Qamar, Ambreen</creatorcontrib><creatorcontrib>Ghuman, Faiza</creatorcontrib><creatorcontrib>Yamin, Rabia</creatorcontrib><creatorcontrib>Ahmad, Nausheen</creatorcontrib><creatorcontrib>Ishaq, Saqib Muhammad</creatorcontrib><creatorcontrib>Gajdács, Márió</creatorcontrib><creatorcontrib>Patel, Isha</creatorcontrib><creatorcontrib>Jamshed, Shazia</creatorcontrib><title>Pediatricians’ Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan</title><title>Healthcare (Basel)</title><description>Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.</description><subject>Antibiotics</subject><subject>Children & youth</subject><subject>clinical management guidelines</subject><subject>Clinical medicine</subject><subject>community-acquired pneumonia</subject><subject>Drug resistance</subject><subject>Family physicians</subject><subject>Health facilities</subject><subject>Hospitals</subject><subject>Infectious diseases</subject><subject>Intensive care</subject><subject>lower respiratory tract infections</subject><subject>Mortality</subject><subject>Pakistan</subject><subject>Pathogens</subject><subject>pediatricians</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Pneumonia</subject><subject>Questionnaires</subject><issn>2227-9032</issn><issn>2227-9032</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNplks9u1DAQxiMEolXpA3CzxIXLgv8ksXNBqlbQrlTEHuDAyZrYk10vib21nUq98QC8QF-PJ8HLVoiCL7ZnvvnZ-maq6iWjb4To6Nstwpi3BiJ2tKWSsifVKedcLjoq-NO_zifVeUo7WlbHhBLN8-pE1JxKxcRp9WON1kGOzjjw6ef3e7IM034sF4MkB5K3SJaj887ASD6Chw1O6DO5nJ3FEsdEhhAPRdPsXb5bXJib2UW0ZO1xnoJ3QJwnKz-Az4mAt-RrmP2GLLdutBH9IbuGby5l8C-qZwOMCc8f9rPqy4f3n5dXi-tPl6vlxfXC1JLmBZeMKay7uje8pQOXXEGLjelbsB23WCuAFvqhZNEapVTTG1YMkqJtjRoGcVatjlwbYKf30U0Q73QAp38HQtxoiNmZEbVq-0GClE2rZI2c9iD4QBvBrBVMyLaw3h1Z-7mfynPFnAjjI-jjjHdbvQm3WpX-CNYUwOsHQAw3M6asJ5cMjiN4DHPSvKlVzahSokhf_SPdhTn6YtVBVZfeNpwWFTuqTAwpRRz-fIZRfRgd_d_oiF8IMLq8</recordid><startdate>20210609</startdate><enddate>20210609</enddate><creator>Shakeel, Sadia</creator><creator>Iffat, Wajiha</creator><creator>Qamar, Ambreen</creator><creator>Ghuman, Faiza</creator><creator>Yamin, Rabia</creator><creator>Ahmad, Nausheen</creator><creator>Ishaq, Saqib Muhammad</creator><creator>Gajdács, Márió</creator><creator>Patel, Isha</creator><creator>Jamshed, Shazia</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-4941-3124</orcidid><orcidid>https://orcid.org/0000-0003-1270-0365</orcidid></search><sort><creationdate>20210609</creationdate><title>Pediatricians’ Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan</title><author>Shakeel, Sadia ; 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Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34207813</pmid><doi>10.3390/healthcare9060701</doi><orcidid>https://orcid.org/0000-0003-4941-3124</orcidid><orcidid>https://orcid.org/0000-0003-1270-0365</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Antibiotics Children & youth clinical management guidelines Clinical medicine community-acquired pneumonia Drug resistance Family physicians Health facilities Hospitals Infectious diseases Intensive care lower respiratory tract infections Mortality Pakistan Pathogens pediatricians Pediatrics Physicians Pneumonia Questionnaires |
title | Pediatricians’ Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan |
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