Service d'Accueil des Urgences Pédiatriques, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris and Université Paris 7 Denis Diderot, 48 Boulevard Sérurier, 75019, Paris, France.
Eur J Clin Microbiol Infect Dis. 2012 Jul;31(7):1295-303. doi: 10.1007/s10096-011-1442-4. Epub 2011 Oct 16.
Acute respiratory tract infections (ARTIs) are the main reason for antibiotic prescription in children. In 2005, the French Drug Agency published guidelines to minimise inappropriate use of antibiotics for ARTI. The purpose of this study was to assess the impact of implementing these guidelines in a paediatric emergency department. We retrospectively analysed data collected prospectively in a French paediatric emergency department from November 2005 (date of guideline implementation) to October 2009. For each child diagnosed with ARTI, we collected age, diagnosis, and prescribed antibiotics. We computed antibiotic prescription rates in the study population. During the study period, 53,055 children were diagnosed with ARTI and 59% of the 22,198 antibiotic prescriptions given at discharge were related to ARTI. The proportion of ARTI patients given antibiotic prescriptions fell from 32.1% during the first year to 21% in year 4 (p<10(-4), Cochran-Armitage test). Amoxicillin-clavulanic acid and amoxicillin accounted for 50% and 34% of antibiotic prescriptions for ARTI, respectively. French antibiotic guidelines led to significant decreases in antibiotic prescription for ARTI in our paediatric emergency department.
急性呼吸道感染（ARTI）是儿童开具抗生素处方的主要原因。2005 年，法国药品管理局发布了指导方针，以尽量减少 ARTIs 抗生素的不当使用。本研究旨在评估在儿科急诊部门实施这些指南的效果。我们回顾性分析了 2005 年 11 月（指南实施日期）至 2009 年 10 月在法国儿科急诊部门前瞻性收集的数据。对于每例确诊为 ARTI 的患儿，我们收集了年龄、诊断和开出处方的抗生素。我们计算了研究人群中的抗生素处方率。在研究期间，53055 名儿童被诊断为 ARTI，出院时开具的 22198 份抗生素处方中有 59%与 ARTI 有关。接受抗生素处方的 ARTI 患者比例从第一年的 32.1%下降到第四年的 21%（p<10(-4)，Cochran-Armitage 检验）。阿莫西林-克拉维酸和阿莫西林分别占 ARTI 抗生素处方的 50%和 34%。法国抗生素指南导致我们儿科急诊部门对 ARTI 的抗生素处方显著减少。
