Kristiansson C, Reilly M, Gotuzzo E, Rodriguez H, Bartoloni A, Thorson A, Falkenberg T, Bartalesi F, Tomson G, Larsson M
Department of Public Health Science, Division of International Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
Trop Med Int Health. 2008 Mar;13(3):434-41. doi: 10.1111/j.1365-3156.2008.02019.x.
To describe the health-seeking behaviour and use of antibiotics in the urban community of Yurimaguas in the Amazonian area of Peru.
Cross-sectional survey of caregivers of 798 children aged 6-72 months by interview using a semi-structured questionnaire. Reported symptoms were classified as illnesses where antibiotics would or would not be recommended based on principles of the integrated management of childhood illnesses algorithm.
Forty-one per cent of consultations were with health care professionals; 71% of antibiotics were obtained through the formal public health sector and prescribed mainly by medical doctors. All prescribed antibiotics were on the Peruvian essential drugs list. When prescribing, doctors and nurses hardly discriminated between illnesses where antibiotic treatment was or was not indicated; there was no significant difference in antibiotic prescribing rates between the two (doctors, P = 0.24; nurses, P = 0.32). Not all caregivers sought help for children with severe symptoms.
Although most of the antibiotics were prescribed by doctors and nurses, they were commonly prescribed for illnesses where they were not indicated. The use of antibiotics needs to be rationalized, and barriers to health care must be overcome.
描述秘鲁亚马逊地区尤里马瓜斯城市社区的就医行为及抗生素使用情况。
采用半结构化问卷，通过访谈对798名6至72个月大儿童的照料者进行横断面调查。根据儿童疾病综合管理算法原则，将报告的症状归类为推荐或不推荐使用抗生素的疾病。
41%的就诊是与医疗保健专业人员进行的；71%的抗生素是通过正规公共卫生部门获得的，主要由医生开具。所有开具的抗生素均在秘鲁基本药物清单上。在开处方时，医生和护士在是否需要使用抗生素治疗的疾病之间几乎没有区别对待；两者之间的抗生素处方率没有显著差异（医生，P = 0.24；护士，P = 0.32）。并非所有照料者都会为有严重症状的儿童寻求帮助。
虽然大多数抗生素是由医生和护士开具的，但它们通常被用于不适用的疾病。抗生素的使用需要合理化，并且必须克服医疗保健的障碍。
