Unnecessary prescribing of antibiotics to healthy/asymptomatic school-age carriers of potentially pathogenic bacteria

Saudi Med J. 2019 Apr;40(4):405-408. doi: 10.15537/smj.2019.4.24004.

Abstract

Objectives: To re-draw attention to the unnecessary prescribing of antibiotics.

Methods: We monitored nasopharyngeal colonization by 3 potentially pathogenic bacteria, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae type b in 81 children between the ages of 6 and 7 years who attended the same primary school. The children's health status was also monitored, without using antimicrobial treatment for healthy/asymptomatic carriers. Nasopharyngeal swabs were collected on 6 occasions during autumn months, from mid-September to mid-December 2016. The children who fell ill during the study were treated at the Ear, Nose and Throat Clinic, Sisters of Mercy University Hospital Center, Zagreb, Croatia.

Results: Four hundred and sixty-three nasopharyngeal swabs were collected. Each child had at least one positive swab result. Bacterial colonization with Streptococcus pyogenes had the highest colonization rate. During the study, 83% of the children were healthy/asymptomatic carriers with no clinical signs of disease, while 17% became ill. The statistical results showed that the increase in all examined bacteria was statistically significant.

Conclusions: Our study results showed that positive bacterial findings in nasopharyngeal swabs from clinically healthy carriers were not an indication for antibiotic therapy.

MeSH terms

  • Anti-Bacterial Agents* / adverse effects
  • Carrier State / microbiology*
  • Child
  • Female
  • Haemophilus influenzae type b / isolation & purification*
  • Haemophilus influenzae type b / pathogenicity
  • Humans
  • Inappropriate Prescribing / prevention & control*
  • Male
  • Nasopharynx / microbiology*
  • Schools
  • Seasons
  • Streptococcus pneumoniae / isolation & purification*
  • Streptococcus pneumoniae / pathogenicity
  • Streptococcus pyogenes / isolation & purification*
  • Streptococcus pyogenes / pathogenicity
  • Time Factors

Substances

  • Anti-Bacterial Agents