Pharmacoepidemiology of common colds and upper respiratory tract infections in children and adolescents in Germany

BMC Clinical Pharmacology

Hildtraud Knopf²  Ingrid-Katharina Wolf²  Giselle Sarganas²  Nathalie Eckel¹ 

[1] German Institute of Human Nutrition Potsdam-Rehbrücke, Department of Molecular Epidemiology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Potsdam, Germany;Robert Koch-Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66 12101, Berlin, Germany

关键词: KiGGS;    Children;    Antibiotics;    Pharmacotherapy;    cold medicines;    Cough &;    Upper respiratory tract infection;    Common cold;   

Others  :  1084859
DOI  :  10.1186/2050-6511-15-44

 received in 2013-12-12, accepted in 2014-08-06,  发布年份 2014

【 摘 要 】

Background

Medicines to treat common colds (CC) and upper respiratory tract infections (URTI) are widely used among children, but there are only few data about treatments actually applied for these diseases. In the present study we analyze the prevalence and correlations of self-medicated and prescribed drug use for the treatment of CCs and URTIs among children and adolescents in Germany.

Methods

Medicine use during the week preceding the interview was recorded among 17,450 children (0–17 years) who participated in the drug interview of the 2003–2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The definition of CCs and URTIs in the present study included the WHO-ICD-10 codes J00, J01.0, J01.9, J02.0, J02.9, J03.0, J03.9, J04.0, J06.8, J06.9, J11.1, J11.8, R05 and R07.0. Using the complex sample method, the prevalence and associated socio-demographic factors of self-medication, prescribed medicines and antibiotics were defined.

Results

13.8% of the participating girls and boys use drugs to treat a CC or an URTI. About 50% of this group use prescribed medications. Among the users of prescribed medication, 11.5% use antibiotics for the treatment of these diseases. Looking at all prescribed medicines we find associations with younger age, immigration background, and lower social status. Antibiotic use in particular is associated with female sex, higher age, residency in the former East Germany and immigration background.

Conclusions

The use of medicines to treat CCs or URTIs is widespread among children and adolescents in Germany. Thus, longitudinal studies should investigate the risks associated with this drug use. Differences in socio-demographic variables regarding exposure to antibiotic use indicate that there could be an implausible prescribing behavior among physicians in Germany.

【 授权许可】

   
2014 Eckel et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Kamtsiuris P, Atzpodien K, Ellert U, Schlack R, Schlaud M: [Prevalence of somatic diseases in German children and adolescents. Results of the German health interview and examination survey for children and adolescents (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:686-700.
• [2]Padberg J, Bauer T: [Common cold]. Dtsch Med Wochenschr 2006, 131:2341-2349.
• [3]Stickler GB, Smith TF, Broughton DD: Review: the common cold. Eur J Pediatr 1985, 144:4-8.
• [4]Lorber B: Perspectives: the common cold. J Gen Intern Med 1996, 11:229-236.
• [5]Gebel J, Teichert-Barthel U, Hornbach-Beckers S, Vogt A, Kehr B, Littmann M, Kupfernagel F, Ilschner C, Simon A, Exner M: [Hygiene tips for kids. Concept and examples of realisation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008, 51:1304-1313.
• [6]Jahnsen K: Arzneimitteltherapie im Kindes- und Jugendalter [in German]. GEK-Arzneimittelreport 2008, 61:98-111.
• [7]Du Y, Knopf H: Self-medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS). Br J Clin Pharmacol 2009, 68:599-608.
• [8]Rimsza ME, Newberry S: Unexpected infant deaths associated with use of cough and cold medications. Pediatrics 2008, 122:318-322.
• [9]Schaefer MK, Shehab N, Cohen AL, Budnitz DS: Adverse events from cough and cold medications in children. Pediatrics 2008, 121:783-787.
• [10]Bücheler R, Meisner C, Kalchthaler B, Mohr H, Schröder H, Mörike K, Schwoerer P, Schwab M, Gleiter CH: “Off-label”Verschreibung von Arzneimitteln in der ambulanten Versorgung von Kindern und Jugendlichen [in German]. Dtsch Med Wochenschr 2002, 127:2551-2557.
• [11]Knopf H, Wolf IK, Sarganas G, Zhuang W, Rascher W, Neubert A: Off-label medicine use in children and adolescents: results of a population-based study in Germany. BMC Public Health 2013, 13:631.
• [12]Arroll B, Kenealy T, Falloon K: Are antibiotics indicated as an initial treatment for patients with acute upper respiratory infections? A review. NZJM 2008, 121:63-70.
• [13]Fahey T, Stocks N, Thomas T: Systematic review of the treatment of upper respiratory tract infection. Arch Dis Child 1998, 79:225-230.
• [14]Kern WV: Antibiotika und Chemotherapeutika [in German]. In Arzneiverordnungs-Report 2007: Aktuelle Daten, Kosten, Trends und Kommentare. Edited by Schwabe U, Paffrath D. Berlin Heidelberg NewYork Tokyo: Springer Verlag; 2008:287-311.
• [15]Schröder H, Nink K, Günther J, Kern WV: Antibiotika: Solange sie noch wirken… [in German]. GGW 2003, 3:7-16.
• [16]Kurth BM, Bergmann KE, Hölling H: The National child and adolescent health survey. The complete concept. Gesundheitswesen 2002, 64(Suppl 1):3-11.
• [17]Kamtsiuris P, Lange M, Schaffrath Rosario A: [The German health interview and examination survey for children and adolescents (KiGGS): sample design, response and nonresponse analysis]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:547-556.
• [18]Knopf H: [Medicine use in children and adolescents. Data collection and first results of the German health interview and examination survey for children and adolescents (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:863-870.
• [19]Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA: Medication use among children <12 years of age in the United States: results from the Slone Survey. Pediatrics 2009, 124:446-454.
• [20]Headley J, Northstone K: Medication administered to children from 0 to 7.5 years in the Avon longitudinal study of parents and children (ALSPAC). Eur J Clin Pharmacol 2007, 63:189-195.
• [21]Tobi H, Meijer WM, Tuinstra T, de Jong-van den Berg LT: Socio-economic differences in prescription and OTC drug use in Dutch adolescents. Pharm World Sci 2003, 25:203-206.
• [22]Sturkenboom MCJM, Verhamme KMC, Nicolosi A, Murray ML, Neubert A, Caudri D, Picelli G, Sen EF, Giaquinto C, Cantarutti L, Baiardi P, Felisi MG, Ceci A, Wong ICK: Drug use in children: cohort study in three European countries. BMJ 2008, 337:2245-2245.
• [23]Baran S, Teul I, Ignys-O’Byrne A: Use of over-the-counter medications in prevention and treatment of upper respiratory tract infections. J Physiol Pharmacol 2008, 59:135-143.
• [24]Kahan E, Giveon SM, Zalevsky S, Imber-Shachar Z, Kitai E: Behavior of patients with flu-like symptoms: consultation with physician versus self-treatment. IMAJ 2008, 2:421-425.
• [25]Nash DR, Harman J, Wald ER, Kelleher KJ: Antibiotic prescribing by primary care physicians for children with upper respiratory tract infections. Arch Pediatr Adolesc Med 2002, 156:1114-1119.
• [26]Meropol SB, Chen Z, Metlay JP: Reduced antibiotic prescribing for acute respiratory infections in adults and children. Br J Gen Pract 2009, 59:e321-e328.
• [27]Moro ML, Marchi M, Gagliotti C, Di Mario S, Resi D, Progetto Bambini a Antibiotici [ProBA]” Regional Group: Why do paediatricians prescribe antibiotics? Results of an Italian regional project. BMC PEdiatr 2009, 9:69.
• [28]Robert Koch-Institut, Bundeszentrale für gesundheitliche Aufklärung: Erkennen – Bewerten – Handeln: Zur Gesundheit von Kindern und Jugendlichen in Deutschland [in German]. Berlin: Robert Koch-Institut; 2008.
• [29]Gonzales R, Steiner JF, Sande MA: Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA 1997, 278:901-904.
• [30]Abbas S, Ihle P, Heymans L, Kupper-Nybelen J, Schubert I: [Differences in antibiotic prescribing between general practitioners and pediatricians in Hessen, Germany]. Dtsch Med Wochenschr 2010, 135:1792-1797.
• [31]Velasco E, Eckmanns T, Espelage W, Barger A, Krause G: Einflüsse auf die ärztliche Verschreibung von Antibiotika in Deutschland (EVA-Studie): Abschlussbericht an das Bundesministerium für Gesundheit [in German]. Berlin: Robert Koch-Institut; 2009. [Report from the Department for Infectious Disease Epidemiology]
• [32]Hedin K, Andre M, Hakansson A, Mölstad S: A population based study of different antibiotic prescribing in different areas. Br J Gen Pract 2006, 56:680-685.
• [33]Soma M, Slapgård H, Lerberg M, Lindbaek M: [Patients’ expectations of antibiotics for acute respiratory tract infections]. Tidsskr Nor Laegeforen 2005, 125:1994-1997.
• [34]Rousounidis A, Papaevangelou V, Hadjipanayis A, Panagakou S, Theodoridou M, Syrogiannopoulos G, Hadjichristodoulou C: Descriptive study on parents’ knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections in Cyprus. Int J Environ Res Public Health 2011, 8:3246-3262.
• [35]Altiner A, Knauf A, Moebes J, Sielk M, Wilm S: Acute cough: a qualitative analysis of how GPs manage the consultation when patients explicitly or implicitly expect antibiotic prescriptions. Fam Pract 2004, 21:500-506.
• [36]Sahlan S, Wollny A, Brockmann S, Fuchs A, Altiner A: Reducing unnecessary prescriptions of antibiotics for acute cough: adaptation of a leaflet aimed at Turkish immigrants in Germany. BMC Fam Pract 2008, 9:57.