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评估巴西儿童的抗生素处方和使用情况。

Evaluation of the prescription and use of antibiotics in Brazilian children.

机构信息

Universidade de Sorocaba, Sorocaba, SP, Brazil.

出版信息

Braz J Infect Dis. 2013 May-Jun;17(3):332-7. doi: 10.1016/j.bjid.2012.10.025. Epub 2013 Apr 19.

Abstract

INTRODUCTION

Inappropriate use of antibiotics leads to increased levels of bacterial resistance making it difficult to treat upper respiratory tract infections. The appropriate use of these drugs has a fundamental role in controlling resistance and in success of treatment of childhood infections. Therefore, the aim of this study was to assess the prescription and use of antibiotics for Brazilian children.

METHODS

The use of antibiotics in 160 children was monitored in two Primary Health Centers by questionnaires administered to parents and caregivers that assessed the social, demographic and clinical conditions of the children. Furthermore, the antibiotic use pattern was ascertained in these children and compared to the recommendations of the Brazilian and international guidelines.

RESULTS

The use of these drugs had an inverse relationship with children breast-fed to six months of age, showing that breast-fed children had a tendency to use less of these drugs. There was great variability in the amoxicillin doses used for upper respiratory infections ranging from 8.2 to 91.9mg/kg/day. The doses used in most treatments were far below the doses recommended in the Brazilian and international guidelines (50% and 97%, respectively).

CONCLUSION

Although there are guidelines for the use of these medications, compliance is still very low, leading to under dosage and therapeutic failures. It is essential for pediatricians to be aware of and comply with the guidelines, avoid personal decisions and take measures based on strong clinical evidence. The proper use of these medications, in addition to greater therapeutic success, decreases the possibility of the appearance of resistant microorganisms.

摘要

引言

抗生素的不恰当使用会导致细菌耐药性增加,从而使上呼吸道感染的治疗变得更加困难。这些药物的合理使用在控制耐药性和成功治疗儿童感染方面起着至关重要的作用。因此,本研究旨在评估巴西儿童抗生素的处方和使用情况。

方法

通过向父母和照顾者发放问卷,在两个基层医疗中心监测了 160 名儿童的抗生素使用情况,该问卷评估了儿童的社会、人口统计学和临床状况。此外,还确定了这些儿童的抗生素使用模式,并将其与巴西和国际指南的建议进行了比较。

结果

这些药物的使用与六个月大时母乳喂养的儿童呈反比关系,表明母乳喂养的儿童使用这些药物的倾向较低。用于上呼吸道感染的阿莫西林剂量差异很大,范围从 8.2 至 91.9mg/kg/天。大多数治疗中使用的剂量远低于巴西和国际指南推荐的剂量(分别为 50%和 97%)。

结论

尽管有抗生素使用指南,但遵守情况仍然很低,导致剂量不足和治疗失败。儿科医生必须了解并遵守指南,避免个人决策,并根据强有力的临床证据采取措施。这些药物的正确使用不仅可以提高治疗成功率,还可以降低耐药微生物出现的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43a2/9427416/0abc8ace174e/gr1.jpg

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