Department of Paediatrics, Lady Hardinge Medical College & associated Kalawati Saran Children's Hospital, New Delhi, India.
Ital J Pediatr. 2011 Sep 5;37:40. doi: 10.1186/1824-7288-37-40.
Acute wheezers for the first time in life are an important target group for efforts aimed at reducing unnecessary antibiotic use.
To evaluate the effect of clinical, laboratory and radiological data on the decision to prescribe antibiotics to paediatric patients with first time wheezing as well as to seek criteria that would justify antibiotic use.
A prospective study was made of 47 previous healthy children admitted to our hospital with first time wheezing in life between October 2008- March 2009. All the patients were treated as per the treating unit's protocol with oxygen, bronchodilators with or without antibiotics. The cases were analyzed after discharge and the characteristics of those treated with antibiotics (n = 23) were compared with those who were not (n = 24) and analyzed statistically to find the predictors for antibiotic usage.
The mean age of the study groups was 5.8 (+/- 5.1) months. Among the clinical and investigational parameters, presence of predominant crackles and abnormalities on radiograph were the major determinants for antibiotic usage. There were no significant differences in final outcome between these groups.
Antibiotic usage in first time wheezers is still quite prevalent. Presence of crackles and radiological abnormalities often prompt the usage of antibiotics in such cases.
首次发作急性喘息的患儿是减少不必要使用抗生素的目标人群。
评估临床、实验室和影像学数据对首次喘息患儿使用抗生素的决策的影响,并寻求可证明使用抗生素合理的标准。
对 2008 年 10 月至 2009 年 3 月间因首次发作喘息而入住我院的 47 例既往健康的儿童进行前瞻性研究。所有患者均按照治疗单位的方案进行治疗,给予氧疗、支气管扩张剂,必要时给予抗生素。出院后对病例进行分析,并比较抗生素治疗组(n=23)和非抗生素治疗组(n=24)的特征,并进行统计学分析,以寻找抗生素使用的预测因素。
研究组的平均年龄为 5.8(+/-5.1)个月。在临床和检查参数中,主要爆裂音的存在和影像学异常是抗生素使用的主要决定因素。两组的最终结果无显著差异。
首次发作喘息患儿中抗生素的使用仍然相当普遍。爆裂音和影像学异常的存在常常促使此类情况下使用抗生素。