Zhang Yuan, Zou Wen, Zhang Yinghui, Ye Weimin, Chen Xingdong, Liu Qian, Liu Huandi, Si Chunfeng, Jia Hongying
Center of Evidence-based Medicine, Second Hospital of Shandong University, Jinan, Shandong, China.
Department of Pharmacy, Second Hospital of Shandong University, Jinan, Shandong, China.
PLoS One. 2015 Nov 16;10(11):e0142999. doi: 10.1371/journal.pone.0142999. eCollection 2015.
China introduced a new policy regarding the management of antibiotic use. We evaluated the reasonableness of antibiotic use among children suffering from intussusception before and after policy. A retrospective study was conducted involving 234 young children with intussusception who were treated between January 1, 2011 and December 30, 2013. Demographics and detailed antibiotics regimens were collected. χ2 test was used to evaluate differences between the phase I (preintervention, n = 68) and phase II (postintervention, n = 166). We determined that the overall antibiotic use rate following successful air enema reduction was 41% (97/234), which decreased from 99% (67/68) in phase I to 18% (30/166) in phase II. In phase I, prophylactic antibiotic usage reached up to 84% (56/67). The quantity of aztreonam for injection accounted for 63% (45/71), and cefamandole nafate for injection accounted for 25% (18/71). In phases II, prophylactic antibiotic usage were reduced to 13% (4/30). The quantity of aztreonam for injection was decreased to 12% (4/33) and cefamandole nafate for injection was 3% (1/33). Antibiotics' options were more diverse. In conclusion, policy intervention was effective in addressing some aspects of antibacterial drug usage among young children with intussusception. However, excessive drug use remains a public health problem. The guidelines for the antibiotic management of intussusception for children must be established in China.
中国出台了一项关于抗生素使用管理的新政策。我们评估了该政策实施前后肠套叠患儿抗生素使用的合理性。进行了一项回顾性研究，纳入了2011年1月1日至2013年12月30日期间接受治疗的234例肠套叠幼儿。收集了人口统计学数据和详细的抗生素治疗方案。采用χ2检验评估第一阶段（干预前，n = 68）和第二阶段（干预后，n = 166）之间的差异。我们确定空气灌肠复位成功后的总体抗生素使用率为41%（97/234），从第一阶段的99%（67/68）降至第二阶段的18%（30/166）。在第一阶段，预防性抗生素使用率高达84%（56/67）。注射用氨曲南的使用量占63%（45/71），注射用头孢孟多酯钠占25%（18/71）。在第二阶段，预防性抗生素使用率降至13%（4/30）。注射用氨曲南的使用量降至12%（4/33），注射用头孢孟多酯钠为3%（1/33）。抗生素的选择更加多样化。总之，政策干预在解决肠套叠幼儿抗菌药物使用的某些方面是有效的。然而，药物过度使用仍然是一个公共卫生问题。中国必须制定儿童肠套叠抗生素管理指南。
