General practitioner management of viral pharyngitis in children under 3 years of age.

The aim of this study was to assess the management of viral pharyngitis, by general practitioners. Each practitioner (n = 356, response rate 80%) was interviewed by telephone after reading a clinical case description (2-year- old child with fever [39 degrees C] pharyngitis and mucosal nasal discharge ). Questions focused on the motives for an eventual antibiotic prescription . Fifty-four per cent of practitioners would prescribe an antibiotic (amoxi cillin: 70%, josamycin: 11%, 1st generation cephalosporin: 9%, penicillin V : 2%). There is no significant statistical correlation between antibiotic p rescribing and age, sex, type of practice, or the presentation of a joint w age-earning activity. Adjusted odds ratios according to logistic regression analysis show that practitioners regularly attending to children and allop athic practitioners are those who prescribe antibiotics most and that the p robability for prescribing an antibiotic is lower when practitioners believ e that the condition is viral in origin, that antibiotic therapy may favor the emergence of resistant mutants, and when they feel involved in the appr opriate use of medications. Although this study was conducted 4 months afte r the publication of guidelines on pediatric upper respiratory tract infect ion treatment it demonstrates a persisting gap between expert and health au thority recommendations and medical practice. (C) 1999 Elsevier Paris.