McCaig Linda F, Besser Richard E, Hughes James M
Ambulatory Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 6525 Belcrest Rd, Room 952, Hyattsville, MD 20782, USA.
JAMA. 2002 Jun 19;287(23):3096-102. doi: 10.1001/jama.287.23.3096.
Annual rates of antimicrobial prescribing for children by office-based physicians increased from 1980 through 1992. The development of antimicrobial resistance, which increased for many organisms during the 1990s, is associated with antimicrobial use. To combat development of antimicrobial resistance, professional and public health organizations undertook efforts to promote appropriate antimicrobial prescribing.
To assess changes in antimicrobial prescribing rates overall and for respiratory tract infections for children and adolescents younger than 15 years.
DESIGN, SETTING, AND PARTICIPANTS: National Ambulatory Medical Care Survey data provided by 2500 to 3500 office-based physicians for 6500 to 13 600 pediatric visits during 2-year periods from 1989-1990 through 1999-2000.
Population- and visit-based antimicrobial prescribing rates overall and for respiratory tract infections (otitis media, pharyngitis, bronchitis, sinusitis, and upper respiratory tract infection) among children and adolescents younger than 15 years.
The average population-based annual rate of overall antimicrobial prescriptions per 1000 children and adolescents younger than 15 years decreased from 838 (95% confidence interval [CI], 711-966) in 1989-1990 to 503 (95% CI, 419-588) in 1999-2000 (P for slope <.001). The visit-based rate decreased from 330 antimicrobial prescriptions per 1000 office visits (95% CI, 305-355) to 234 (95% CI, 210-257; P for slope <.001). For the 5 respiratory tract infections, the population-based prescribing rate decreased from 674 (95% CI, 568-781) to 379 (95% CI, 311-447; P for slope <.001) and the visit-based prescribing rate decreased from 715 (95% CI, 682-748) to 613 (95% CI, 570-657; P for slope <.001). Both population- and visit-based prescribing rates decreased for pharyngitis and upper respiratory tract infection; however, for otitis media and bronchitis, declines were only observed in the population-based rate. Prescribing rates for sinusitis remained stable.
The rate of antimicrobial prescribing overall and for respiratory tract infections by office-based physicians for children and adolescents younger than 15 years decreased significantly between 1989-1990 and 1999-2000.
1980年至1992年期间，门诊医生给儿童开具抗菌药物的年增长率有所上升。在20世纪90年代，许多微生物的抗菌药物耐药性有所增加，这与抗菌药物的使用有关。为了对抗抗菌药物耐药性的发展，专业和公共卫生组织努力促进抗菌药物的合理使用。
评估15岁以下儿童和青少年总体及呼吸道感染的抗菌药物处方率变化。
设计、地点和参与者：1989 - 1990年至1999 - 2000年期间，由2500至3500名门诊医生提供的全国门诊医疗护理调查数据，涉及6500至13600次儿科就诊。
15岁以下儿童和青少年总体及呼吸道感染（中耳炎、咽炎、支气管炎、鼻窦炎和上呼吸道感染）基于人群和就诊次数的抗菌药物处方率。
15岁以下儿童和青少年每1000人的总体抗菌药物处方年均率从1989 - 1990年的838（95%置信区间[CI]，711 - 966）降至1999 - 2000年的503（95% CI，419 - 588）（斜率P <.001）。基于就诊次数的处方率从每1000次门诊330份抗菌药物处方（95% CI，305 - 355）降至234（95% CI，210 - 257；斜率P <.001）。对于5种呼吸道感染，基于人群的处方率从674（95% CI，568 - 781）降至379（95% CI，311 - 447；斜率P <.001），基于就诊次数的处方率从715（95% CI，682 - 748）降至613（95% CI，570 - 657；斜率P <.001）。咽炎和上呼吸道感染基于人群和就诊次数的处方率均下降；然而，对于中耳炎和支气管炎，仅在基于人群的处方率中观察到下降。鼻窦炎的处方率保持稳定。
1989 - 1990年至1999 - 2000年期间，门诊医生给15岁以下儿童和青少年开具的总体及呼吸道感染抗菌药物处方率显著下降。
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