Ding Hui, Yang Yonghong, Lu Quan, Wang Yi, Chen Yuan, Deng Li, Wang Aihua, Deng Qiulian, Zhang Hong, Wang Chuanqing, Liu Lan, Xu Xiwei, Wang Li, Shen Xuzhuang
Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
J Trop Pediatr. 2008 Aug;54(4):238-42. doi: 10.1093/tropej/fmm118. Epub 2008 Jan 25.
In order to demonstrate antibiotic usage in Chinese Pediatric Intensive Care Units (PICUs), and provide some data to further study on relation of antimicrobial use and resistance. We reviewed the use of antibiotics in Chinese PICUs from 2002 to 2006. All data, including general data and antibiotic use data, were obtained from five PICUs of pediatric teaching hospitals in China. The results of antibiotic use were expressed as defined daily doses (DDDs) per 100 patient-days by WHO in this study. All 12 743 patients were included from the five PICUs in this study. Length of stay in PICUs was essentially unchanged, but the percentage of antimicrobial costs vs. drug costs dramatically decreased in this study period (p < 0.01). The percentage of empiric treatment decreased by year (from 82.2% to 70.2%). while the percentage of therapeutic treatment increased by year (from 11.2% to 24.2%) from 2002 to 2006. Total antibiotic usage decreased from 72.1 DDDs per 100 patient-days to 35.5 DDDs per 100 patient-days from 2002 to 2006 (p < 0.05). The significant increase was found in the DDDs per 100 patient-days of second generation cephalosporins in this study (p < 0.05). While usages of the some antibiotics decreased, for example penicillins, third-generation cephalosporins, and macrolides in this study period. The data of antimicrobial use were obtained from five PICUs of biggest pediatric teaching hospital in this 5-year period, which could serve as a basis of antibiotic treatment and a benchmark in future study of antibiotic use.
为了展示中国儿科重症监护病房（PICUs）的抗生素使用情况，并提供一些数据以进一步研究抗菌药物使用与耐药性的关系。我们回顾了2002年至2006年中国PICUs的抗生素使用情况。所有数据，包括一般数据和抗生素使用数据，均来自中国儿科教学医院的五个PICUs。在本研究中，抗生素使用结果以世界卫生组织定义的每日剂量（DDDs）每100患者日表示。本研究纳入了五个PICUs的全部12743名患者。PICUs的住院时间基本未变，但在本研究期间，抗菌药物费用占药品费用的百分比大幅下降（p<0.01）。经验性治疗的百分比逐年下降（从82.2%降至70.2%），而从2002年到2006年，针对性治疗的百分比逐年上升（从11.2%升至24.2%）。从2002年到2006年，抗生素总使用量从每100患者日72.1 DDDs降至每100患者日35.5 DDDs（p<0.05）。在本研究中，发现第二代头孢菌素每100患者日的DDDs显著增加（p<0.05）。而在本研究期间，一些抗生素的使用量减少，例如青霉素、第三代头孢菌素和大环内酯类药物。这5年期间抗菌药物使用数据来自最大的儿科教学医院的五个PICUs，可为抗生素治疗提供依据，并作为未来抗生素使用研究的基准。
