Nitsch-Osuch A, Gyrczuk E, Wardyn A, Życinska K, Brydak L
Department of Family Medicine, Medical University of Warsaw, 1a Banacha St., 02-097, Warsaw, Poland.
National Influenza Center, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
Adv Exp Med Biol. 2016;905:25-31. doi: 10.1007/5584_2015_198.
The important factor in the development of resistance to antibiotics is their overuse, especially for viral respiratory infections. The aim of the study was to find out the frequency of the antibiotic therapy administrated to children with influenza. A total of 114 children younger than 59 months seeking care for the acute respiratory tract infection was enrolled into the study. The patients had influenza-like symptoms: fever > 38 °C, cough, and sore throat of less than 4 days duration. Nasal and pharyngeal swabs were tested for influenza A and B virus with a real-time PCR. Thirty six cases of influenza were diagnosed: 34 of influenza A (H3N2) and 2 of influenza B. The rate of influenza infection was 32 % in the study group. The antibiotic therapy was ordered for 58 % patients with influenza. Antibiotics were given less frequently in the outpatient setting (33 %) compared with the hospitalized patients (93 %) (p < 0.05). The most often administrated antibiotics were amoxicillin with clavulanic acid, cefuroxime, and amoxicillin. None of the patients received oseltamivir. Antibiotics were overused, while antivirals were underused among children with influenza. To improve health care quality, more efforts in the diagnosis of influenza and the appropriate use of antimicrobials and antivirals are required.
抗生素耐药性产生的重要因素是其过度使用,尤其是用于病毒性呼吸道感染时。本研究的目的是了解对患流感儿童进行抗生素治疗的频率。共有114名年龄小于59个月因急性呼吸道感染而寻求治疗的儿童纳入本研究。这些患者有流感样症状:发热>38°C、咳嗽且咽痛持续时间少于4天。采用实时聚合酶链反应对鼻拭子和咽拭子进行甲型和乙型流感病毒检测。确诊36例流感:34例甲型(H3N2)流感和2例乙型流感。研究组流感感染率为32%。58%的流感患者接受了抗生素治疗。与住院患者(93%)相比,门诊患者抗生素使用频率较低(33%)(p<0.05)。最常使用的抗生素是阿莫西林克拉维酸、头孢呋辛和阿莫西林。没有患者接受奥司他韦治疗。流感儿童中抗生素过度使用,而抗病毒药物使用不足。为提高医疗质量,需要在流感诊断以及抗菌药物和抗病毒药物的合理使用方面做出更多努力。