Schindler Christoph, Krappweis Jutta, Morgenstern Ingolf, Kirch Wilhelm
Institute of Clinical Pharmacology, Medical Faculty, Technical University, Fiedlerstrasse 27, D-01307 Dresden, Germany.
Pharmacoepidemiol Drug Saf. 2003 Mar;12(2):113-20. doi: 10.1002/pds.786.
Limited information is available about systemic antibiotic use among children in Germany. We therefore assessed prescription patterns by office-based physicians to analyse antibiotic consumption in early childhood. A total of 331 children < 6 years were eligible for inclusion. The number of antibiotic prescriptions, consumed daily doses, number of treatment courses, types of antibiotics and diagnoses for prescribing were determined. The prevalence of systemic antibiotic treatment was 42.9%. Antibiotic consumption was highest between 2 and 3 years of age (55.8%). The percentage of children receiving one, two or three courses of antibiotic treatment was 49.3, 28.2 and 16.2%, respectively. Acute otitis media (32.2%), upper respiratory tract infections (18.9%), tonsillitis (15.9%) and acute bronchitis (15.4%) were principal indications for treatment. Macrolides were most frequently prescribed (48.1%), followed by penicillin V (21.3%), broad-spectrum penicillins (14.3%), sulfonamides (10.5%) and cephalosporins (5.8%). Antibiotics not recommended for particular indication were selected in 5-43% of cases. The considerable prescription of systemic antibiotics to children in many European countries is also the case in Germany. A noteworthy trend emerged for suboptimal prescribing with second-line antibiotics. As such treatment may be associated with the development of bacterial resistance, improved guidelines for antibiotic treatment should be drawn up and enforced.
关于德国儿童全身性抗生素使用的信息有限。因此，我们评估了门诊医生的处方模式，以分析幼儿期的抗生素消费情况。共有331名6岁以下儿童符合纳入标准。确定了抗生素处方数量、每日服用剂量、治疗疗程数量、抗生素类型以及处方诊断。全身性抗生素治疗的患病率为42.9%。抗生素消费量在2至3岁之间最高（55.8%）。接受一、二或三个疗程抗生素治疗的儿童比例分别为49.3%、28.2%和16.2%。急性中耳炎（32.2%）、上呼吸道感染（18.9%）、扁桃体炎（15.9%）和急性支气管炎（15.4%）是主要治疗指征。最常开具的是大环内酯类药物（48.1%），其次是青霉素V（21.3%）、广谱青霉素（14.3%）、磺胺类药物（10.5%）和头孢菌素（5.8%）。在5%至43%的病例中选择了不推荐用于特定指征的抗生素。在许多欧洲国家，德国也存在给儿童大量开具全身性抗生素的情况。出现了一个值得注意的趋势，即二线抗生素的处方不合理。由于这种治疗可能与细菌耐药性的发展有关，因此应制定并执行改进的抗生素治疗指南。
