ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2018-1

5 3. Kirkwood CD, et al. The rotavirus vaccine development pipeline. Vaccine Apr 2017, in press. http://doi.org/10.1016/j.vaccine.2017.03.076 4. Rudinsky, S. L., Carstairs, K. L., Reardon, J. M., Simon, L. V., Riffenburgh, R. H. and Tanen, D. A. (2009), Serious Bacterial Infections in Febrile Infants in the Post–Pneumococcal Conjugate Vaccine Era. Academic Emergency Medicine, 16: 585–590. .-..94DE tdoi:10.1111/j.1553- 2712.2009.00444.x Antibiotic Use in Children In the same issue of The Journal of Pediatrics 1 , Youngster, et al, describe a cross- national analysis of antibiotic use in children. Following trends in Germany, Italy, South Korea, Norway, Spain and the United States, for almost 75 million patient years during the years 2008-2012, antibiotics dispensing was followed and categorized. Rates of antibiotic courses ranged from 3.41 per patient year (South Korea) to 0.5 (Norway). Class of antibiotics was also identified with first-line penicillins comprising of the majority of prescriptions written in Norway (64.8%), as opposed to less than 10 percent in areas of Italy and in South Korea. This study demonstrates that varying use of antibiotics in children, both in rates of use and class of antibiotics prescribed. Comment: Overuse of antibiotics is a well known problem with drastic effects that are allowing the evolution of resistant strains of bacteria and superbugs. Coupled with limited hope for newer antibiotics entering the market we face an ever growing danger. Development of newer vaccines (such as PCV13, described above) have reduced some of the risks for SBIs and the subsequent need for antibiotics, yet for many physicians, the challenge remains to avoid “covering” the patient just in case. In 2013, Low, et al 2 , examined similar trends in Israel, demonstrating variations in practice. More needs to be done to monitor antibiotic prescribing in Israel and limiting its use. Educating doctors, as well as parents with guidelines for the former and palatable information for the latter is of paramount importance. Bottom Line: Much can and needs to be done to reduce extraneous antibiotic use 1. Youngster Ilan, et al. Antibiotic Use in Children – A Cross-National Analysis of 6 Countries. J Pediatr 2017;182:239-44. http://dx.doi.org10.1016/j.jpeds.2016.11.027 2. Low, M., Nitzan, O., Bitterman, H. et al. Infection (2013) 41: 401. https://doi.org/10.1007/ s15010-012-0332-8