Carande Elliott J, Pollard Andrew J, Drysdale Simon B
Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Level 2, Children's Hospital, Oxford OX3 9DU, UK.
Can J Infect Dis Med Microbiol. 2016;2016:9139537. doi: 10.1155/2016/9139537. Epub 2016 Oct 20.
In 1995, the European Society for Paediatric Infectious Diseases (ESPID) carried out a survey of its members to assess the variation in management of respiratory syncytial virus (RSV) bronchiolitis. The aim of the current study was to carry out a similar survey 20 years later to assess how the management had changed. An electronic, structured, English language survey, based on the United Kingdom National Institute for Health and Care Excellence (NICE) bronchiolitis draft guideline, was sent to ESPID members in March 2015. Questions asked included information on treatment practices of infants with bronchiolitis and doctor demographics. We received responses from 135 doctors (14% of the ESPID members) who worked in 115 hospitals. 56% of the doctors used a written guideline to manage bronchiolitic infants. All doctors stated that they isolated individually or in cohorts all hospitalised bronchiolitis infants. The level of oxygen saturation suggested as an indication to administer supplemental oxygen varied between <89% and <95%. We found significant reductions in the use of ribavirin, bronchodilators, and corticosteroids from 1995 to 2015 (ribavirin 57% to 13%, < 0.0001; bronchodilators 95% to 82%, = 0.0024; corticosteroids 81% to 45%, < 0.0001). Although variability in management remains high, encouragingly significantly fewer doctors are prescribing ribavirin, bronchodilators, and corticosteroids compared to 20 years ago.
1995年，欧洲儿科传染病学会（ESPID）对其成员进行了一项调查，以评估呼吸道合胞病毒（RSV）细支气管炎管理方面的差异。本研究的目的是在20年后开展一项类似调查，以评估管理方式发生了怎样的变化。2015年3月，一项基于英国国家卫生与临床优化研究所（NICE）细支气管炎指南草案的电子结构化英文调查问卷被发送给了ESPID成员。所提问题包括有关细支气管炎婴儿治疗方法及医生人口统计学信息。我们收到了来自115家医院的135名医生（占ESPID成员的14%）的回复。56%的医生使用书面指南来管理患细支气管炎的婴儿。所有医生均表示，他们对所有住院的细支气管炎婴儿进行单独或分组隔离。作为给予补充氧气指征的血氧饱和度水平建议在<89%至<95%之间有所不同。我们发现，从1995年到2015年，利巴韦林、支气管扩张剂和皮质类固醇的使用量显著减少（利巴韦林从57%降至13%，<0.0001；支气管扩张剂从95%降至82%，P = 0.0024；皮质类固醇从81%降至45%，<0.0001）。尽管管理方式的差异仍然很大，但令人鼓舞的是，与20年前相比，开具利巴韦林、支气管扩张剂和皮质类固醇处方的医生明显减少。
