Baidya Sandip, Hazra Avijit, Datta Supratim, Das Amal Kanti
Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
Department of Pediatrics, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
Indian J Pharmacol. 2017 Jan-Feb;49(1):10-15. doi: 10.4103/0253-7613.201034.
Antimicrobials are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in Eastern India, to generate a profile of antimicrobial use and suspected adverse drug reactions (ADRs) attributable to them.
Hospitalized children of either sex, aged between 1 month and 12 years, were studied. Baseline demographic and clinical features, duration of hospital stay, antimicrobials received in hospital along with dosing and indications and details of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or death.
Over the 1 year study period, 332 admissions were screened. The prevalence of antimicrobial use was 79.82%. The majority of the 265 children who received antimicrobials were males (61.10%) and hailed from rural and low socioeconomic background. Median age was 36 months. Six children died, 43 were transferred out, and the rest discharged. In most instances, either 2 (40%) or a single antibiotic (39.6%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antivirals, antimalarials, and antiprotozoals were used occasionally. Average number of antimicrobials per patient was 2.0 ± 1.27; the majority (84.1%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antimicrobial treatment ranged between 1 and 34 days, with a median of 7 days. Six ADRs were noted of which half were skin rash and the rest loose stools.
The profile of antimicrobial use is broadly similar to earlier Indian studies. Apparent overuse of multiple antimicrobials per prescription and the parenteral route requires exploration. Antimicrobials are being used empirically in the absence of policy. ADRs to antimicrobials are occasional and usually mild. The baseline data can serve in situation analysis for antibiotic prescribing guidelines.
抗菌药物在三级医疗机构中经常使用。我们对印度东部一家教学医院收治的儿童进行了一项观察性研究，以了解抗菌药物的使用情况以及与之相关的疑似药物不良反应（ADR）。
研究对象为年龄在1个月至12岁之间的住院儿童，不限性别。记录基线人口统计学和临床特征、住院时间、住院期间接受的抗菌药物及其剂量、用药指征以及与其使用相关的疑似ADR的详细信息。对每位患者进行随访，直至出院、入住儿科重症监护病房或死亡。
在为期1年的研究期间，共筛查了332例入院病例。抗菌药物的使用率为79.82%。在接受抗菌药物治疗的265名儿童中，大多数为男性（61.10%），来自农村且社会经济背景较低。中位年龄为36个月。6名儿童死亡，43名儿童转出，其余儿童出院。在大多数情况下，使用了2种（40%）或1种抗生素（39.6%）。头孢曲松、阿莫西林克拉维酸钾、阿米卡星、万古霉素和氨苄西林是主要使用的药物。抗病毒药物、抗疟药物和抗原虫药物偶尔使用。每位患者使用抗菌药物的平均数量为2.0±1.27；大多数（84.1%）通过静脉途径给药，初始选择通常是经验性的。处方通常使用通用名。抗菌药物治疗时间为1至34天，中位时间为7天。记录到6例ADR，其中一半为皮疹，其余为腹泻。
抗菌药物的使用情况与印度早期的研究大致相似。每个处方明显过度使用多种抗菌药物以及静脉途径给药的情况需要进一步探讨。在缺乏政策的情况下，抗菌药物是凭经验使用的。抗菌药物引起的ADR偶尔发生，通常较为轻微。这些基线数据可用于抗生素处方指南的情况分析。
