IRD UMR216, Mère et enfant face aux infections tropicales, Paris, France.
Acta Trop. 2013 Aug;127(2):87-90. doi: 10.1016/j.actatropica.2013.04.004. Epub 2013 Apr 12.
Rational use of antibiotics in poor-resource settings countries is challenging. In order to assess the factors related to antibiotic prescription, a cross sectional study was carried out in four school infirmaries from February to June 2008 in the district of Allada in Benin. For each patient, socio-demographic characteristics, symptoms motivating medical visits, diagnosis and therapeutic prescriptions were collected. A malaria rapid diagnostic test was used in case of fever. Data were entered and validated with Epidata(®) software, and analysed with STATA 11(®) software. One thousand six hundred and thirty medical visits occurred during the study period. Fever was reported by 57% of children. Malaria was the leading diagnosis (32%), followed by respiratory infection (17.5%). Antibiotic was prescribed to 40% of the children. Respiratory infection and skin disorders were positively related to antibiotic usage [OR=59.5 (33.4-105.7); P<10(-3) and OR=6.4 (4.6-8.8); P<10(-3) respectively]. Malaria [OR=0.11 (0.03-0.11); P<10(-3)] and fever of unknown origin [OR=0.05 (0.03-0.11); P<10(-3)] were negatively related to antibiotic usage. Further clinical surveys and trials aimed at rationalizing antibiotics usage in this area should focus on the management of acute respiratory illnesses.
在资源匮乏国家合理使用抗生素具有挑战性。为了评估与抗生素处方相关的因素，我们在 2008 年 2 月至 6 月期间在贝宁阿拉拉区的 4 所校医室进行了一项横断面研究。对于每一位患者，我们收集了社会人口统计学特征、促使就诊的症状、诊断和治疗处方。对于发热的患者，我们使用了疟疾快速诊断测试。数据输入和验证使用了 EpiData（®）软件，分析使用了 STATA 11（®）软件。在研究期间共发生了 1630 次就诊。57%的儿童报告有发热。疟疾是最主要的诊断（32%），其次是呼吸道感染（17.5%）。40%的儿童开具了抗生素。呼吸道感染和皮肤疾病与抗生素使用呈正相关[比值比（OR）=59.5（33.4-105.7）；P<10(-3)和 OR=6.4（4.6-8.8）；P<10(-3)]。疟疾[OR=0.11（0.03-0.11）；P<10(-3)]和不明原因发热[OR=0.05（0.03-0.11）；P<10(-3)]与抗生素使用呈负相关。进一步旨在该地区合理使用抗生素的临床研究和试验应集中于急性呼吸道疾病的管理。
