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5 岁以下儿童呼吸道感染:澳大利亚全科医疗中的当前管理。

Respiratory tract infections among children younger than 5 years: current management in Australian general practice.

机构信息

1 Monash University, Melbourne, VIC, Australia.

出版信息

Med J Aust. 2015 Mar 16;202(5):262-6. doi: 10.5694/mja14.00090.

Abstract

OBJECTIVE

To explore the current management in Australian general practice of common respiratory tract infections (RTIs) in children younger than 5 years.

DESIGN, SETTING AND PARTICIPANTS: Analysis of data from a sample of 4522 general practitioners who participated in the Bettering the Evaluation and Care of Health (BEACH) cross-sectional survey, April 2007 to March 2012. Consultations with children younger than 5 years were analysed.

MAIN OUTCOME MEASURES

GPs' management of four common RTIs (acute upper RTI [URTI], acute bronchitis/bronchiolitis, acute tonsillitis, and pneumonia) in association with six management options: antibiotic medications; prescribed or supplied non-antibiotic medications; medications advised for over-the-counter purchase; referrals; pathology testing; and counselling.

RESULTS

Of 31 295 encounters recorded, at least one of the four selected paediatric RTIs was managed at 8157 encounters. URTI was managed 18.6 times per 100 GP patient encounters, bronchitis/bronchiolitis 4.2 times, acute tonsillitis 2.7 times, and pneumonia 0.6 times per 100 encounters. Antibiotics were prescribed most frequently for tonsillitis and least frequently for URTI. Male GPs prescribed antibiotics for URTI significantly more often than female GPs, while older GPs prescribed antibiotics for URTI more often than younger GPs.

CONCLUSION

GP management of paediatric RTIs in Australia varied according to the clinical problem and with age and sex of the GP. Further research into parents' and health professionals' attitudes and practices regarding the role of antibiotics, over-the-counter medications, and hygiene will help maintain favourable management practices.

摘要

目的

探讨澳大利亚普通科医生对 5 岁以下儿童常见呼吸道感染(RTI)的现行管理方法。

设计、地点和参与者:对参加 2007 年 4 月至 2012 年 3 月 Bettering the Evaluation and Care of Health(BEACH)横断面调查的 4522 名普通科医生样本数据进行分析。对年龄小于 5 岁的儿童进行了分析。

主要观察指标

4 种常见 RTI(急性上呼吸道感染[URTI]、急性支气管炎/细支气管炎、急性扁桃体炎和肺炎)与 6 种管理方案(抗生素药物、开处方或提供非抗生素药物、建议购买非处方药物、转诊、病理检查和咨询)相关的 GP 管理。

结果

在记录的 31295 次就诊中,至少有 1 种选定的儿科 RTI 在 8157 次就诊中得到了处理。URTI 每 100 名 GP 患者就诊中管理 18.6 次,支气管炎/细支气管炎 4.2 次,急性扁桃体炎 2.7 次,肺炎 0.6 次。抗生素最常开给扁桃体炎患者,而最不常开给 URTI 患者。男性 GP 开给 URTI 的抗生素显著多于女性 GP,而年长的 GP 开给 URTI 的抗生素多于年轻的 GP。

结论

澳大利亚普通科医生对儿科 RTI 的处理方法因临床问题、GP 的年龄和性别而异。进一步研究父母和卫生专业人员对抗生素、非处方药物和卫生的态度和做法,将有助于维持有利的管理做法。

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