Palikhe N
Department of Pharmacology, Kathmandu Medical College, Duwakot, KTM.
Kathmandu Univ Med J (KUMJ). 2004 Jan-Mar;2(1):6-12.
Antibiotics are among the most commonly prescribed drugs in paediatrics. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use is of growing concern and strict antibiotic policies should be warranted. Before such policies can be implemented, detailed knowledge of antibiotic prescribing practice is important.
The main objective is to study the prescribing practice of antibiotic in hospital in-patient.
A prospective follow up study of one and half month's duration was undertaken during November- December of 2003. A total number of 121 patients were taken for the study.
The average number of drugs per patient was 5.01+/-1.36 and antibiotics per patient was 2.41+/-1.02. More than 98% of the patients were exposed to, at least, two drugs. Among 121 patients clinically diagnosed with infectious diseases and treated with antibiotics, specimens were taken for culture in only 24 cases i.e. (19.8%) to identify pathogenic organisms. Only 13 specimens showed positive culture results. Infants less than 1 year received antibiotics more frequently than 1-5 and 5-12 years (40, 31 and 29%, P<0.001, P=0.000). Seventy-five percentage of the total antibiotics were administered parentrally. Cephalosporin was the top most frequently prescribed antibiotics followed by penicillin group. Significant difference was found between age group of patient and disease encountered (chi2 = 42.95, P=0.000).
The fact that children below 1 year or infants are at special risk of receiving multiple courses of antibiotics, together with the knowledge that antibiotic resistance develops in this setting; suggest that strategies to control antibiotic use should focus on these patients' populations.
抗生素是儿科最常用的处方药之一。由于医疗保健成本总体上升、药物处方缺乏一致性以及抗生素耐药性的出现，抗生素使用的监测和控制日益受到关注，应制定严格的抗生素政策。在实施此类政策之前，详细了解抗生素处方实践非常重要。
主要目的是研究医院住院患者的抗生素处方实践。
2003年11月至12月进行了为期一个半月的前瞻性随访研究。共纳入121例患者进行研究。
每位患者的平均用药数为5.01±1.36，每位患者的抗生素数为2.41±1.02。超过98%的患者至少使用了两种药物。在121例临床诊断为传染病并接受抗生素治疗的患者中，仅24例（19.8%）采集了标本进行培养以鉴定病原体。只有13份标本显示培养结果为阳性。1岁以下婴儿比1 - 5岁和5 - 12岁儿童更频繁地接受抗生素治疗（40%、31%和29%，P<0.001，P = 0.000）。75%的抗生素通过静脉注射给药。头孢菌素是最常处方的抗生素，其次是青霉素类。患者年龄组与所患疾病之间存在显著差异（χ2 = 42.95，P = 0.000）。
1岁以下儿童或婴儿特别容易接受多疗程抗生素治疗，而且在这种情况下会产生抗生素耐药性，这表明控制抗生素使用的策略应侧重于这些患者群体。
