Al Khaja Khalid A J, Al-Ansari Thuraya M, Damanhori Awatif H H, Sequeira Reginald P
Department of Pharmacology & Therapeutics, Arabian Gulf University, Kingdom of Bahrain.
J Trop Pediatr. 2006 Dec;52(6):390-3. doi: 10.1093/tropej/fml020. Epub 2006 May 8.
This nationwide prescription-based study was undertaken to evaluate antimicrobial prescribing for infants, and to identify prescribing errors in infants in 20 primary care health centres of Bahrain. Data was collected on a daily basis by pharmacists in May 2004. Antimicrobials ranked the 5th most common drugs prescribed in infants; beta-lactams, notably amoxycillin and cephalexin, comprised 81.6% of overall prescribed antimicrobials. Antimicrobials were prescribed to approximately one out of four infants (23.8%), prescribed more often to infants aged 9-12 months of age. Approximately one-fifth (22%) of infants received antimicrobials at subtherapeutic daily doses. The prescribing errors were related to dosage (39.2%), strength/doses (26.4%), frequency of dosing (19.2%), and duration of therapy (4.5%). Antimicrobial dosage prescribed in relation to infants' age revealed a positive correlation for amoxycillin (r = 0.264; p < 0.0001), cephalexin (r = 0.223; p = 0.029), erythromycin (r = 0.127; p = 0.284), and a negative correlation for metronidazole (r = -0.183; p = 0.415). Overt use of antimicrobials in infants, and prescription-writing errors (in dosages and frequency of dosing) were common in primary care. Dosage adjustment in relation to developmental stages of infants has received inadequate attention. Effective strategies to improve prescription writing skills are urgently required.
这项基于全国处方的研究旨在评估婴儿的抗菌药物处方情况，并识别巴林20家初级保健健康中心中婴儿的处方错误。2004年5月，药剂师每天收集数据。抗菌药物是婴儿处方中第五大最常用药物；β-内酰胺类药物，尤其是阿莫西林和头孢氨苄，占所有处方抗菌药物的81.6%。约四分之一的婴儿（23.8%）使用了抗菌药物，9至12个月大的婴儿使用频率更高。约五分之一（22%）的婴儿接受的抗菌药物每日剂量低于治疗剂量。处方错误与剂量（39.2%）、浓度/剂量（26.4%）、给药频率（19.2%）和治疗持续时间（4.5%）有关。根据婴儿年龄开具的抗菌药物剂量显示，阿莫西林（r = 0.264；p < 0.0001）、头孢氨苄（r = 0.223；p = 0.029）、红霉素（r = 0.127；p = 0.284）呈正相关，甲硝唑（r = -0.183；p = 0.415）呈负相关。婴儿抗菌药物的过度使用以及处方书写错误（剂量和给药频率方面）在初级保健中很常见。针对婴儿发育阶段的剂量调整未得到充分关注。迫切需要有效的策略来提高处方书写技能。
