Salles M, de Monte M, Dubus J-C, Diot P
Unité de médecine infantile, URMITE 6236, CNRS, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Arch Pediatr. 2008 Oct;15(10):1520-4. doi: 10.1016/j.arcped.2008.07.015. Epub 2008 Sep 19.
The aim of the study was to analyze the data of the NUAGES survey (a survey on the practice of nebulization in France), concerning the prescriptions of nebulized steroids from 514 pediatricians.
The reason why nebulization was chosen as a delivery route, the diseases motivating the prescription, the age of the patients, the kind of drug used, and the prescription and device modalities were studied.
Efficacy in treating various respiratory diseases was the main reason cited for using nebulization, in particular severe persistent asthma (76%). Pediatricians prescribed nebulization mainly to infants (60%). The most frequently used drug was budesonide suspension (89%), but the intravenous route for steroids (18%) and drug admixtures (62%) were also proposed by nebulization. A specific prescription for the nebulizer was given in 75% of the cases, with the type of interface to use specified in 66%.
Pediatricians consider that nebulization is well adapted to young children. Although the proper steroid is usually chosen, unfortunately, it is often prescribed with other drugs, with 1 prescription out of 4 not following the recommendations. Prescription of the device is not optimal and may compromise the efficacy of the treatment.
Nebulization is a potential mode of delivery for steroids that is difficult to prescribe and warrants improved pediatrician training.
本研究的目的是分析NUAGES调查（一项关于法国雾化治疗实践的调查）的数据，该数据涉及514名儿科医生开具的雾化类固醇处方。
研究了选择雾化作为给药途径的原因、促使开具处方的疾病、患者年龄、所用药物种类以及处方和设备使用方式。
治疗各种呼吸道疾病的有效性是使用雾化的主要原因，尤其是重度持续性哮喘（76%）。儿科医生主要给婴儿开具雾化处方（60%）。最常用的药物是布地奈德混悬液（89%），但也有18%的情况通过雾化建议使用静脉注射类固醇，62%的情况建议使用药物混合制剂。75%的病例给出了雾化器的具体处方，66%的情况指明了要使用的接口类型。
儿科医生认为雾化非常适合幼儿。虽然通常会选择合适的类固醇，但不幸的是，它经常与其他药物一起开具，每4张处方中有1张不符合推荐标准。设备的处方并不理想，可能会影响治疗效果。
雾化是一种类固醇给药的潜在方式，但开具处方存在困难，需要加强儿科医生的培训。
