Ashe David, Patrick Patricia A, Stempel Michelle M, Shi Qiuhu, Brand Donald A
Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
J Pediatr Health Care. 2006 May-Jun;20(3):192-7. doi: 10.1016/j.pedhc.2005.12.017.
Antibiotic overuse promotes resistant strains of bacteria and puts patients at risk for adverse reactions. Given the use of educational posters in government-sponsored public health campaigns, this study examined the effectiveness of a waiting room poster in reducing excessive antibiotic use in clinical practice.
Investigators conducted a 1-month trial of an educational poster with historical controls using three private pediatric group practices in Westchester County, New York. Children between the ages of 6 months and 10 years at the time of a visit to diagnose and treat symptoms of respiratory illness were enrolled as subjects. Antibiotic prescriptions for children with respiratory illnesses seen during the poster month were compared with prescriptions written during three 1-month historical control periods. The proportion of visits that resulted in a prescription for an antibiotic served as the outcome measure.
Overall, 326 of the 720 patients (45.2%) enrolled in the study were treated with an antibiotic. Multiple logistic regression analysis revealed no statistically significant difference in the proportion of visits resulting in an antibiotic prescription among the 4 study months (P = .79), indicating that the educational poster had no effect on antibiotic use.
Public education in the form of a waiting room poster was not sufficient to decrease antibiotic prescriptions. This finding has implications for current large-scale programs and for health care providers as they continue to attempt to educate patients on the appropriate use of antibiotics.
抗生素的过度使用会促使细菌产生耐药菌株,并使患者面临不良反应的风险。鉴于政府资助的公共卫生运动中使用了教育海报,本研究调查了候诊室海报在减少临床实践中过度使用抗生素方面的效果。
研究人员在纽约州韦斯特切斯特县的三家私立儿科诊所,采用历史对照法对一张教育海报进行了为期1个月的试验。年龄在6个月至10岁之间前来诊断和治疗呼吸道疾病症状的儿童被纳入研究对象。将张贴海报当月期间就诊的患有呼吸道疾病儿童的抗生素处方,与三个为期1个月的历史对照期内开具的处方进行比较。以开具抗生素处方的就诊比例作为结果指标。
总体而言,该研究纳入的720名患者中有326名(45.2%)接受了抗生素治疗。多因素逻辑回归分析显示,在4个研究月份中,开具抗生素处方的就诊比例没有统计学上的显著差异(P = 0.79),这表明教育海报对抗生素的使用没有影响。
以候诊室海报形式进行的公众教育不足以减少抗生素处方。这一发现对当前的大规模项目以及医疗保健提供者具有启示意义,因为他们仍在继续尝试教育患者正确使用抗生素。