Ali Syed Rehan, Ahmed Shakeel, Lohana Heeramani
Department of Paediatrics & Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan.
Int J Pediatr. 2013;2013:832857. doi: 10.1155/2013/832857. Epub 2013 Dec 25.
Objectives. (1) To determine the indications, frequency, and types of antibiotics used in hospitalized paediatric patients at tertiary care hospital and (2) to evaluate whether the prescribed antibiotics were based on the isolation of organism and their sensitivity. Study Design. Descriptive observational hospital based study. Results. A total of 131 patients were included over 6 months of study period, in whom antibiotics were prescribed at the time of admission. The majority were between 1 and 5 years of age. M : F ratio was 1 : 1. Fever was the commonest symptom (in 84% of cases) followed by gastroenteritis. Blood culture was done in 114 cases (87%) and was positive only in 10 (8.8%). The commonest organism isolated from blood was Salmonella Typhi. Ceftriaxone was found to be the most frequently prescribed antibiotic as an empirical therapy. 102 (77.86%) patients received Ceftriaxone, followed by ampicillin. The antibiotics were probably used on the basis of clinical condition rather than the result of blood culture, as yield of blood culture was quite low. Conclusion. Our study showed an unjustified use of antibiotics regardless of the admission and discharge diagnosis in acute febrile illnesses. Further on, inappropriate practice of using Ceftriaxone was noted in LRTI and pneumonia. Efforts are needed to educate physicians about the rational use of antibiotics.
目的。（1）确定三级护理医院住院儿科患者使用抗生素的指征、频率和类型，以及（2）评估所开具的抗生素是否基于病原体的分离及其敏感性。研究设计。基于医院的描述性观察性研究。结果。在为期6个月的研究期间，共纳入131例入院时开具了抗生素的患者。大多数患者年龄在1至5岁之间。男女比例为1∶1。发热是最常见的症状（84%的病例），其次是肠胃炎。114例（87%）进行了血培养，仅10例（8.8%）呈阳性。从血液中分离出的最常见病原体是伤寒沙门氏菌。头孢曲松被发现是最常作为经验性治疗开具的抗生素。102例（77.86%）患者接受了头孢曲松治疗，其次是氨苄西林。由于血培养阳性率相当低，抗生素的使用可能是基于临床状况而非血培养结果。结论。我们的研究表明，在急性发热性疾病中，无论入院和出院诊断如何，抗生素的使用都是不合理的。此外，在下呼吸道感染和肺炎中，发现了使用头孢曲松的不当做法。需要努力对医生进行抗生素合理使用方面的教育。
