Center of Evidence-based Medicine, Second Hospital of Shandong University, Jinan, China.
School of Public Health, Shandong University, Jinan, China.
Sci Rep. 2018 Apr 17;8(1):6064. doi: 10.1038/s41598-018-24415-x.
The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.
中国政府自 2011 年以来发布了颁布抗菌药物临床应用政策。在空气灌肠复位成功的小儿肠套叠中,预防性使用抗生素是一个具有挑战性的问题。对于低危感染的肠套叠,预防性使用抗生素的临床价值的数据有限。对 2011 年 1 月 1 日至 2013 年 12 月 30 日期间 188 例空气灌肠复位成功的小儿肠套叠进行回顾性非随机对照研究。其中 51 例接受预防性抗生素治疗,137 例未接受抗生素治疗。结果显示,两组在年龄、性别、体重、入院时间、复位间隔、腋窝温度、白细胞、中性粒细胞、淋巴细胞、单核细胞、肠系膜淋巴结和并发症方面无显著差异(P>0.05)。国家政策显著改善了低危肠套叠患儿抗生素的临床应用(OR<0.001,P<0.001)。使用抗生素的患儿住院天数较未使用抗生素的患儿长(中位数 27.0 小时 vs 21.0 小时,P=0.003)。在空气灌肠复位成功的低危感染性小儿肠套叠中,预防性使用抗生素似乎价值不大。政策干预对中国抗生素的使用是有效的。