Antibiotic use in the management of children with the common cold at a provincial hospital in Papua New Guinea: a point-prevalence study.

Zamunu, Andree; Pameh, Wendy; Ripa, Paulus; Vince, John; Duke, Trevor

BACKGROUND Antibiotic prescribing for self-limiting viral infections such as the common cold or viral upper respiratory tract infection (URTI) is irrational and increases the risk of antibiotic resistance. However, such a practice is widespread and is likely to be as common in Papua New Guinea as in many other countries. METHODS In a cross-sectional descriptive study, children were recruited who had been diagnosed with a common cold or URTI by attending clinical staff-mostly nurses-in a provincial hospital's children's outpatient department using a standard definition. The frequency of antibiotic prescribing was determined and the clinical knowledge and practices of nurses, health extension officers, community health workers and doctors working in the children's outpatients department regarding the common cold and its management was assessed. RESULTS One hundred and eight children diagnosed with the common cold were enrolled; 89 (82.4%) were prescribed antibiotics. Children with fever on examination, those older than 12 months and those whose symptoms lasted ≥7 days were more likely to be prescribed antibiotics. Of the health workers surveyed, 95% knew that viruses were the cause of the common cold, but 30% thought that antibiotics were needed for treatment. CONCLUSIONS Although among healthcare workers, there was a gap between knowledge of aetiology and knowledge of appropriate management of the common cold, there was a larger apparent gap between that knowledge and practice. Findings from this study could be used to identify interventions promoting rational antibiotic use, targeting both health-care workers and the community.