Zanasi Alessandro, Morcaldi Luigi, Cazzato Salvatore, Mazzolini Massimiliano, Lecchi Marzia, Morselli-Labate Antonio Maria, Mastroroberto Marianna, Dal Negro Roberto W
Italian Association for Cough Study, Bologna.
National Observatory of Health in Childhood and Adolescence (PAIDOSS: Osservatorio Nazionale sulla Salute dell'Infanzia e dell'Adolescenza), Rome.
Clinicoecon Outcomes Res. 2017 Mar 16;9:189-199. doi: 10.2147/CEOR.S129696. eCollection 2017.
Children's cough is a daily concern for most pediatricians. The management of both acute and chronic cough requires a systematic and comprehensive approach. Despite the approved protocols for management, the pediatric assessment of cough and the corresponding prescribing attitude frequently do not fit these protocols, which can be affected by parental suggestions - sometimes substantially.
The objective of this study was to investigate both the perception and the behavior of a representative sample of Italian pediatricians toward cough in real life.
A specific questionnaire consisting of 18 questions was prepared. The questionnaire was completed by 300 pediatricians (all members of PAIDOSS: Italian National Observatory on Health of Childhood and Adolescence) who represented ~300,000 children.
A vast majority of children have cough throughout the year (99.3% of respondents have cough during autumn/winter and 64.7% in spring/summer). Allergic disease is the most frequent suspected cause of chronic cough in children (53%), and this is supported by the high demand for consultations: 73% seek the opinion of allergologists, 62% of otorhinolaryngologists and only 33% of pulmonologists. The majority of pediatricians (92%) reported that they prescribe therapy in acute cough regardless of cough guidelines. Moreover, the survey pointed out the abuse of aerosol therapy (26% in acute cough and 38% in chronic cough) and of antibiotics prescription (22% in acute cough and 42% in chronic cough).
Our survey suggests that some Italian pediatricians' therapeutic attitudes should be substantially improved in order to achieve better management of cough in children and to minimize the burden of cough.
儿童咳嗽是大多数儿科医生日常关注的问题。急性和慢性咳嗽的管理都需要系统而全面的方法。尽管有批准的管理方案，但儿科医生对咳嗽的评估及相应的处方态度往往不符合这些方案，这可能会受到家长建议的影响——有时影响很大。
本研究的目的是调查意大利儿科医生在现实生活中对咳嗽的认知和行为。
编制了一份由18个问题组成的特定问卷。300名儿科医生（均为意大利儿童和青少年健康国家观察站PAIDOSS的成员）填写了问卷，这些儿科医生代表了约30万名儿童。
绝大多数儿童全年都会咳嗽（99.3%的受访者表示儿童在秋冬季节咳嗽，64.7%在春夏季节咳嗽）。过敏性疾病是儿童慢性咳嗽最常见的疑似病因（53%），这一点从高咨询需求中得到了证实：73%的人寻求过敏科医生的意见，62%寻求耳鼻喉科医生的意见，只有33%寻求肺科医生的意见。大多数儿科医生（92%）报告称，无论咳嗽指南如何，他们都会在急性咳嗽时开药治疗。此外，调查指出了雾化治疗的滥用情况（急性咳嗽中占26%，慢性咳嗽中占38%）以及抗生素处方的滥用情况（急性咳嗽中占22%，慢性咳嗽中占42%）。
我们的调查表明，为了更好地管理儿童咳嗽并尽量减轻咳嗽负担，一些意大利儿科医生的治疗态度应大幅改善。
