The Influence of National Guidelines on the Management of Community-Acquired Pneumonia in Children. Do Pediatricians Follow the Recommendations?

This is a retrospective study whose main objective was to analyze the influence of the Polish Guidelines for the Management of Respiratory Tract Infections of 2010 (PGMRTI) on in-hospital treatment of children with community-acquired pneumonia (CAP). Files from four Warsaw hospitals were reviewed to identify children with uncomplicated CAP, treated before (2008-2009) (pre-PGMRTI) and after (2011-2012) (post-PGMRTI) publication of the guidelines. Predefined data on the management were compared. A cohort of 2,359 children (1,081 pre-PGMRTI and 1,278 post-PGMRTI) was included. We found that co-amoxiclav was the most common first-line therapy in children >3 months of age (34.6% and 40.4% pre- and post-PGMRTI, respectively), followed by cefuroxime (31.8% and 20.9% pre- and post-PGMRTI, respectively; p < 0.0001) and macrolides (17.4% and 24.5% pre- and post-PGMRTI, respectively; p < 0.0001). Amoxicillin was rarely used (5.4% and 4.9%, pre- and post-PGMRTI, respectively). The study revealed an overuse of inhaled bronchodilators, corticosteroids, and mucoactive drugs. Blood diagnostic tests were applied to a significant percentage of patients: blood cultures (41.2% and 44.5% pre-and post-PGMRTI, respectively) and serology for atypical pathogens (27.9% and 44.9% pre-and post-PGMRTI, respectively; p < 0.0001). The number of follow-up chest X-rays increased (30.5% and 53.8% pre- and post-PGMRTI, respectively; p < 0.0001). In conclusion, the study demonstrates an unsatisfactory influence of the guidelines on in-hospital management of CAP in children. Despite an explicit recommendation for the use of amoxicillin, it was still underused. Other methods of education and guideline dissemination are needed to optimize the prescribing of antibiotics.

Dietary supplements: a great menace of our time or golden remedy? A cross-sectional study amongschool-aged children.

INTRODUCTION: Dietary supplements (DS) are commonly used as a remedy for various health issues as they are widely advertised and available. AIM: This study aimed to evaluate the prevalence of DS use among school-aged children in Warsaw, the capital city of Poland. Additionally, we evaluated the parents' motivations for DS administration, the frequency of the use of specific compounds and the influence of child's history of allergy on DS use. MATERIAL AND METHODS: Children aged 6-7 years who attended the first grade of primary schools in Warsaw were included into the study. Forty-two out of 170 primary schools in Warsaw were randomly selected of which 38 agreed to participate. The research tool was a self-administered questionnaire. RESULTS: Half of the studied children received DS in the previous 6 months. Fatty acids were the most commonly administered DS (49.8%). The most common reason for administering DS was prevention of diseases (69.1%). The total household income correlated positively with the DS use. History of food allergy was one of the factors which increased the risk of DS use, whereas diagnosis of asthma did not correlate with a higher frequency of DS use. CONCLUSIONS: This study shows the need to educate patients about medical indications for DS use and expected benefits in the specific indications.