Cao Bin, Li Ran, Liu Ying-Mei, Cao Zhi-Xin, Geng Xiu-Qin, Lau Lok-Ting, Lu Jie, Wu Lin, Cui Shu-Feng, Bai Rui-Ting, Yu Chang-Hai, Wang Chen
Department of Infectious Diseases and Clinical Microbiology, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2008 Jul;31(7):483-7.
To study the etiology of influenza-like illness (ILI) in Beijing, and to investigate the impact of antibiotic treatment on outcomes.
This was a prospective cohort study. Patients with diagnosis of influenza-like illness were prospectively enrolled for study of bacterial and viral pathogens. Demographic characteristics, underlying diseases, respiratory and extrapulmonary symptoms, laboratory tests were also collected for analysis of relationship between drug therapy and outcomes.
A total of 476 cases were enrolled between Dec. 2006 and Apr. 2007, of whom 454 cases were used for analysis. Influenza virus was the most common pathogen( n = 197, 43.4%), with other pathogens rarely seen. The mean age of the patients was (33 +/- 13) years, and the ratio of male to female was 1.1:1. Twenty four patients (5.3% ) received influenza vaccine. The rate of antibiotic prescription after onset of illness was 63.4%, but none received antiviral drugs such as Oseltamivir and amantadine. Compared with influenza-negative patients, patients with influenza were older, had more underlying diseases and had greater severity of symptoms such as cough, sore throat, headache and myalgia (but with no statistical differences). The influenza syndrome (T > or = 39 degrees C plus cough, sore throat and headache or myalgia) was more common in the influenza group compared to the influenza-negative patients (P < 0.05). The ratio of antibiotic prescription was 67% in the influenza group, and the total white blood cell and platelet count, percentage of neutrophils were higher in antibiotic treatment patients compared with non-antibiotic treatment patients (P < 0.01). The cost in patients who received antibiotics was twice as much as non-antibiotic treatment patients (P < 0.05), but the defervescence time and respiratory symptom alleviation time did not differ. Cox regression analysis showed that the total white blood count and the differentials (OR value 1.049 and 1.014, respectively), but not antibiotic use were the independent risk factors for longer defervescence time.
Influenza virus was the most common pathogen for adult patients with ILI in Beijing city during the winter and the spring seasons. Antibiotic treatment of adult patients with ILI did not improve illness resolution, while the cost was increased significantly.
研究北京地区流感样疾病（ILI）的病因，并探讨抗生素治疗对其预后的影响。
这是一项前瞻性队列研究。对诊断为流感样疾病的患者进行前瞻性登记，以研究细菌和病毒病原体。收集患者的人口统计学特征、基础疾病、呼吸道及肺外症状、实验室检查结果，分析药物治疗与预后的关系。
2006年12月至2007年4月共纳入476例患者，其中454例用于分析。流感病毒是最常见的病原体（n = 197，43.4%），其他病原体少见。患者平均年龄为（33±13）岁，男女比例为1.1∶1。24例患者（5.3%）接种了流感疫苗。发病后抗生素使用率为63.4%，但无人使用奥司他韦和金刚烷胺等抗病毒药物。与流感阴性患者相比，流感患者年龄更大，基础疾病更多，咳嗽、咽痛、头痛和肌痛等症状更严重（但无统计学差异）。流感组流感综合征（体温≥39℃加咳嗽、咽痛、头痛或肌痛）较流感阴性患者更常见（P < 0.05）。流感组抗生素使用率为67%，抗生素治疗患者的白细胞总数、血小板计数及中性粒细胞百分比高于未使用抗生素治疗的患者（P < 0.01）。使用抗生素患者的费用是非抗生素治疗患者的两倍（P < 0.05），但退热时间和呼吸道症状缓解时间无差异。Cox回归分析显示，白细胞总数及分类（OR值分别为1.049和1.014）而非抗生素使用是退热时间延长的独立危险因素。
冬春季节北京地区成年ILI患者中，流感病毒是最常见的病原体。成年ILI患者使用抗生素治疗不能改善病情转归，反而显著增加费用。
