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[给0至13岁儿童开具全身性感冒和咳嗽药物。一个未解决的问题]

[Prescription of systemic cold and cough drugs to children 0-13 years old. An unresolved problem].

作者信息

Cano Garcinuño A, Casares Alonso I, Rodríguez Barbero J, Pérez García I, Blanco Quirós A

机构信息

Centro de Salud de Villamuriel de Cerrato, Palencia, España.

出版信息

An Pediatr (Barc). 2013 Jan;78(1):43-50. doi: 10.1016/j.anpedi.2012.04.003. Epub 2012 Jun 1.

Abstract

INTRODUCTION AND OBJECTIVES

Upper respiratory tract infections are the most common cause of paediatric consultation, generating a high volume of prescriptions of drugs with unfavourable risk-benefit ratio. The aim of this study is to describe the prescription of systemic cough and cold medicines to children under 14 years of age in Castilla y León and analyse its variability.

POPULATION AND METHODS

A count was made of the prescriptions for the R05 therapeutic subgroup (antitussives and mucolytics) and the R01B pharmacological therapeutic subgroup (nasal decongestants for systemic use), prescribed for children under the age of 14 in the Public Health System between 2005-2010. The number of prescriptions was analysed as crude and age-adjusted rates, as well as a a multivariate analysis (Poisson regression) of the variability associated with health area, the urban/rural environment, age, and year of prescription.

RESULTS

There were 806,785 prescriptions for systemic cough and cold drugs given to an exposed population of 1,580,229 person-years. Prescription rates (per 100 person-years) were 20.7 (antitussives), 7.0 (sympathomimetic) and 23.4 (mucolytics). These drugs were employed more often in children <4 years. The prescription of mucolytics and sympathomimetics was highest at age of 1 year (rates=41.9 and 18.7, respectively) and of antitussives at 3 years (35.7). Multivariate analysis showed that in rural areas the prescription was higher than in urban areas, and that there were also significant differences between health areas.

CONCLUSIONS

Between 2005 and 2010 there was a high prescription of systemic cough and cold medicines, especially in children under 2 years old, and often outside the recommended conditions of use, and there was a high geographic variabilty.

摘要

引言与目的

上呼吸道感染是儿科就诊最常见的原因,导致大量开具风险效益比不佳的药物处方。本研究旨在描述卡斯蒂利亚-莱昂地区14岁以下儿童系统性止咳和感冒药的处方情况,并分析其变异性。

研究对象与方法

统计了2005 - 2010年间公共卫生系统中为14岁以下儿童开具的R05治疗亚组(镇咳药和黏液溶解剂)和R01B药物治疗亚组(全身用鼻减充血剂)的处方。将处方数量分析为粗率和年龄调整率,以及对与健康区域、城乡环境、年龄和处方年份相关的变异性进行多变量分析(泊松回归)。

结果

共开出806,785份系统性止咳和感冒药处方,暴露人群为1,580,229人年。处方率(每100人年)分别为20.7(镇咳药)、7.0(拟交感神经药)和23.4(黏液溶解剂)。这些药物在4岁以下儿童中使用更为频繁。黏液溶解剂和拟交感神经药的处方在1岁时最高(率分别为41.9和18.7),镇咳药在3岁时最高(35.7)。多变量分析表明,农村地区的处方高于城市地区,且不同健康区域之间也存在显著差异。

结论

2005年至2010年间,系统性止咳和感冒药的处方量很高,尤其是在2岁以下儿童中,而且常常超出推荐的使用条件,并且存在很高的地理变异性。

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