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[根据科学证据对急性咽扁桃体炎进行治疗的适宜性]

[Appropriateness of treatment of acute pharyngotonsillitis according to the scientific evidence].

作者信息

Ochoa Sangrador C, Vilela Fernández M, Cueto Baelo M, Eiros Bouza J M, Inglada Galiana L

机构信息

Servicios de Pediatría. Hospital Virgen de la Concha. Zamora. Spain.

出版信息

An Pediatr (Barc). 2003 Jul;59(1):31-40. doi: 10.1016/s1695-4033(03)78145-4.

Abstract

OBJECTIVE

To evaluate the appropriateness of antibiotic prescriptions in children with acute pharyngotonsillitis.

METHODS

A descriptive study was performed in a series of pediatric patients diagnosed with acute pharyngotonsillitis in the emergency rooms of 11 Spanish hospitals. The appropriateness of antibiotic prescriptions was assessed by comparing our clinical practice in the use of antibiotics for pharyngotonsillitis with consensus guidelines developed for this study.

RESULTS

We collected data from 1716 patients with acute pharyngotonsillitis. Antibiotics were prescribed in 80.9 %, mainly according to empirical criteria. The most commonly used antibiotics were amoxicillin (36 %), amoxicillin-clavulanate (22.5 %), cefixime (6.6 %), azithromycin (5.8 %) and cefuroxime (5.2 %). A total of 39.5 % of the patients were aged less than 3 years, of which 75.9 % were treated empirically. Of the prescribed treatments, 22.8 % were considered as the treatment of choice; 22.4 % as alternatives and 54.8 % as inappropriate.

CONCLUSIONS

Antibiotic treatment was prescribed in most of the cases of pharyngotonsillitis and nearly always according to empirical criteria. The number of antibiotic prescriptions was far higher than the expected cases of bacterial pharyngotonsillitis and, in many cases, the antibiotic prescriptions were inappropriate.

摘要

目的

评估急性咽扁桃体炎患儿抗生素处方的合理性。

方法

对西班牙11家医院急诊科一系列诊断为急性咽扁桃体炎的儿科患者进行描述性研究。通过将我们在咽扁桃体炎抗生素使用方面的临床实践与为本研究制定的共识指南进行比较,评估抗生素处方的合理性。

结果

我们收集了1716例急性咽扁桃体炎患者的数据。80.9%的患者使用了抗生素,主要依据经验性标准。最常用的抗生素为阿莫西林(36%)、阿莫西林 - 克拉维酸(22.5%)、头孢克肟(6.6%)、阿奇霉素(5.8%)和头孢呋辛(5.2%)。共有39.5%的患者年龄小于3岁,其中75.9%接受了经验性治疗。在开出的治疗方案中,22.8%被视为首选治疗;22.4%为替代治疗,54.8%为不恰当治疗。

结论

大多数咽扁桃体炎病例都开具了抗生素治疗,且几乎总是依据经验性标准。抗生素处方数量远高于细菌性咽扁桃体炎的预期病例数,并且在许多情况下,抗生素处方是不恰当的。

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