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Rates and determinants of antibiotics and probiotics prescription to children in Asia-Pacific countries

In: Beneficial Microbes
Authors:
J. Zhang The Children’s Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, 310052 Hangzhou, Zhejiang, China P.R.

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D. Cameron Royal Children’s Hospital Melbourne, Department of Gastroenterology, 50 Flemington Road, 3052 Parkville, Australia.

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S.H. Quak Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore.

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M. Kadim Faculty of Medicine, University of Indonesia, Department of Child Health, Jl Salemba Raya Mo 6, 10430 Jakarta, Indonesia.

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N. Mohan Center of Child Health, Department of Pediatrics, Sir Ganga Ram Hospital, 110060 New Delhi, India.

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E. Ryoo Gachon University, Gil Medical Center, Department of Pediatrics, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, South Korea.

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B. Sandhu Bristol Royal Hospital for Children, Department of Pediatric Gastroenterology, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom.

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Y. Yamashiro Juntendo University, Graduate School of Medicine, Probiotics Research Laboratory, 3rd floor, 2-9-8 Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan.

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A. Guarino University of Naples, Unit of Pediatric Infectious Diseases, Via Sergio Pansini 5, 80131 Naples, Italy.

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H. Hoekstra Hieronymus Bosch Teaching Hospital, Department of Pediatrics, H. Dunantstraat 1, 5223 GZ’s-Hertogenbosch, the Netherlands.

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Antibiotic therapy may have important side effects. Guidelines recommend the administration of specific probiotics to reduce the risk of antibiotic-associated diarrhoea (AAD). The rates and determinants of antibiotics and co-prescription of probiotics in children remain poorly known in Asia-Pacific countries, which are very heterogenous in terms of economic development, health care organization and health policies. A survey among general practitioners (GPs) and paediatricians was performed in seven countries of the Asia-Pacific area (Australia, Japan, Indonesia, India, China, Singapore, and South Korea). Physicians completed an online questionnaire that explored their current habits and the determinants for prescribing antibiotics and probiotics. For the 731 physicians who completed the questionnaire (390 paediatricians and 341 GPs), 37% of all consultations for a child led to the prescription of antibiotics (ranging from 17% in Australia to 47% in India). A large majority of physicians (84%) agreed that antibiotics disrupted gut microbiota and considered probiotics an effective intervention to prevent AAD (68%). However, only 33% co-prescribed probiotics with antibiotics (ranging from 13% in Japan to 60% in South Korea). The main reasons for prescribing probiotics were previous episodes of AAD (61%), presence of diarrhoea (55%), prolonged antibiotic treatment (54%) or amoxicillin-clavulanic acid therapy (54%). Although current local guidelines recommend the use of selected probiotics in children receiving antibiotics in Asia-Pacific area, the rates of antibiotics and probiotics prescription significantly vary among countries and are deeply affected by country-related cultural and organisational issues.

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