The impact of national recommendations on antibiotic treatment of community acquired pneumonia. Do pediatricians follow the national guidelines

Background: In 2010 in Poland was published Recommendations for Management of Respiratory Tract Infections (RMRTI) which support medical practitioners in every aspect of management of community acquired pneumonia (CAP). Objective: To analyze the impact of RMRTI on antibiotic prescribing in children with CAP. Material and Methods: We assessed prehospital and hospital antibiotic use in CAP in 4 pediatric hospitals before (2008-2009) and after (2011-2012) RMRTI publication. Results: A group of 2359 children with CAP was enrolled. In outpatients the most common first-line antibiotics were: second generation cephalosporins (CEF), co-amoxiclav and macrolides. There were no differences between pre-recommendation group (PreRG) (n=1081) and post-recommendation group (PostRG) (n=1278). In hospitalized children significant change in first-line therapy was observed in PreRG and PostRG periods: CEF (57.1% vs 16.5% p Conclusion: The study showed that publishing recommendations is not a sufficient form of education. Despite recommendations amoxicillin is still rarely prescribed in CAP in children. Other forms of active teaching are needed to convince clinicians to adhere to the guidelines.