Huang Yu-Hsuan, Huang Yhu-Chering
Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Children's Hospital, Taipei.
Chang Gung Med J. 2005 Nov;28(11):758-64.
Upper respiratory tract infections (URTIs) are mostly caused by viruses. Antibiotic misuse for viral URTIs in children is a serious problem that not only results in selection of resistant strains of bacteria but also wastes millions of dollars each year in Taiwan. Antibiotic resistance among common respiratory bacterial pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Moraxella catarrhalis has become a major issue for public health. The common cold, acute pharyngotonsillitis, acute otitis media, acute sinusitis, acute bronchitis, influenza and acute epiglottitis are the most frequently encountered acute URTIs in out-patient clinics. This article recommends the judicious use of antimicrobial agents for these seven common pediatric URTIs, based on local epidemiological data and the recommendations of the Infectious Disease Society of Taiwan and the American Academy of Pediatrics. With education and behavior modification, practitioners will help to reduce antibiotic overuse, and the goal of reducing antimicrobial resistance may be accomplished.
上呼吸道感染（URTIs）大多由病毒引起。在台湾，儿童病毒性上呼吸道感染滥用抗生素是一个严重问题，不仅会导致耐药菌株的产生，每年还会造成数百万美元的浪费。常见呼吸道细菌病原体如肺炎链球菌、流感嗜血杆菌、金黄色葡萄球菌和卡他莫拉菌的抗生素耐药性已成为公共卫生的一个主要问题。普通感冒、急性咽扁桃体炎、急性中耳炎、急性鼻窦炎、急性支气管炎、流感和急性会厌炎是门诊中最常见的急性上呼吸道感染。本文根据当地流行病学数据以及台湾传染病学会和美国儿科学会的建议，推荐对这七种常见儿童上呼吸道感染合理使用抗菌药物。通过教育和行为改变，从业者将有助于减少抗生素的过度使用，从而实现降低抗菌药物耐药性的目标。
