Mostafavi Nasser, Rashidian Arash, Karimi-Shahanjarini Akram, Khosravi Ardeshir, Kelishadi Roya
Department of Pediatric Infectious Diseases, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Health Management and Economics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Res Med Sci. 2015 May;20(5):429-33. doi: 10.4103/1735-1995.163952.
To investigate the prevalence of antibiotic usage in children aged <5 years with acute respiratory tract illness (ARTI) in Iran.
Data were collected from a national health survey conducted in 2010 (Iran's Multiple Indicator Demographic and Health Survey). Participants of this cross-sectional study were selected by multistage stratified cluster-random sampling from 31 provinces of Iran. Parents of children with <5 years of age responded to questions about the occurrence of any cough during the previous 2 weeks, referral to private/governmental/other health care systems, and utilization of any oral/injection form of antibiotics. Data were analyzed using SPSS software18. The chi-square test was used to determine antibiotic consumption in various gender and residency groups and also a place of residence with the referral health care system.
Of the 9345 children under 5 years who participated in the study, 1506 cases (16.2%) had ARTI during 2 weeks prior to the interview, in whom 1143 (75.9%) were referred to urban or rural health care centers (43.4 vs. 30.4%; P < 0.001). Antibiotics were utilized by 715 (62.6%) of affected children. Injection formulations were used for 150 (13.1%) patients. The frequency of receiving antibiotics was higher in urban than in rural inhabitants (66.0% vs. 57.7% P < 0.05).
The prevalence of total and injection antibiotics usage in children <5 years with ARTI is alarmingly high in Iran. Therefore, interventions to reduce antibiotic use are urgently needed.
调查伊朗5岁以下急性呼吸道疾病(ARTI)儿童的抗生素使用情况。
数据收集自2010年进行的一项全国健康调查(伊朗多指标人口与健康调查)。本横断面研究的参与者通过多阶段分层整群随机抽样从伊朗31个省份中选取。5岁以下儿童的家长回答了有关前两周内是否出现咳嗽、是否转诊至私立/政府/其他医疗保健系统以及是否使用任何口服/注射剂型抗生素的问题。使用SPSS软件18进行数据分析。采用卡方检验确定不同性别和居住群体以及居住地点与转诊医疗保健系统之间的抗生素使用情况。
在参与研究的9345名5岁以下儿童中,1506例(16.2%)在访谈前两周内患有ARTI,其中1143例(75.9%)被转诊至城市或农村医疗保健中心(43.4%对30.4%;P<0.001)。715例(62.6%)患病儿童使用了抗生素。150例(13.1%)患者使用了注射剂型。城市居民接受抗生素治疗的频率高于农村居民(66.0%对57.7%,P<0.05)。
伊朗5岁以下患有ARTI的儿童中,抗生素总体使用和注射使用的比例高得惊人。因此,迫切需要采取干预措施以减少抗生素的使用。