Department of Pediatric Infectious Diseases, Hacettepe University, Medical School, Ankara, Turkey.
Int J Infect Dis. 2010 Jan;14(1):e55-61. doi: 10.1016/j.ijid.2009.03.013. Epub 2009 May 31.
Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices.
In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP).
A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p<0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p=0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p=0.008).
Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.
尽管已经明确了合理使用抗菌药物的原则，但在世界范围内仍存在不合理的处方模式。准确了解抗菌药物的使用情况，包括与抗菌药物使用相关的因素及其影响，对于提高处方实践质量具有重要意义。
本研究采用横断面时点患病率调查方法，在一天内收集了 12 家儿童医院住院患者的数据。比较了不同类型的抗菌药物、适应证、病房以及是否咨询感染病医生（IDP）对处方合理性的影响。
在评估的 1302 例患者中，有 711 例（54.6%）正在接受一种或多种抗菌药物治疗。儿科重症监护病房（75.7%）的抗菌药物处方率最高，而外科病房（37.0%）最低。在接受抗菌药物治疗的 711 例患者中，有 332 例（46.7%）至少有一种药物被认为使用不当。手术病房的不合理用药发生率最高（80.2%），而肿瘤科病房的不合理用药发生率最低（31.8%；p<0.001）。呼吸道感染是抗菌药物使用最常见的适应证（29.4%）。深部感染（54.7%）和呼吸道感染（56.5%）的不合理用药更为常见。氟喹诺酮类药物的不合理使用率（81.8%）高于其他任何药物（p=0.021）。咨询 IDP 似乎可以增加抗菌药物的合理使用（p=0.008）。
在土耳其儿科医院，抗菌药物的不合理使用仍然是一个普遍存在的问题。咨询 IDP 并根据微生物学检测结果开具抗菌药物处方可以减少抗菌药物的不合理使用。
