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早期使用抗生素与儿童肥胖:未来风险对家长和医生而言重要吗?

Early Antibiotics and Childhood Obesity: Do Future Risks Matter to Parents and Physicians?

作者信息

Lipstein Ellen A, Block Jason P, Dodds Cassandra, Forrest Christopher B, Heerman William J, Law J Kiely, Lunsford Douglas, Winkler Paula, Finkelstein Jonathan A

机构信息

1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

2 University of Cincinnati College of Medicine, Cincinnati, OH, USA.

出版信息

Clin Pediatr (Phila). 2019 Feb;58(2):191-198. doi: 10.1177/0009922818809534. Epub 2018 Oct 26.

Abstract

To understand how parents and physicians make decisions regarding antibiotics and whether a potential associated risk of obesity would alter decisions, we conducted a qualitative study of parents and physicians who care for children. Parent focus groups and physician interviews used a guide focused on experience with antibiotics and perceptions of risks and benefits, including obesity. Content analysis was used to understand how a risk of obesity would influence antibiotic decisions. Most parents (n = 59) and physicians (n = 22) reported limited discussion about any risks at the time of antibiotic prescriptions. With an acute illness, most parents prioritized symptomatic improvement and chose to start antibiotics. Physicians' treatment preferences were varied. An obesity risk did not change most parents' or physicians' preferences. Given that parent-physician discussion at the time of acute illness is unlikely to change preferences, public health messaging may be a more successful approach to counter obesity and antibiotics overuse.

摘要

为了解家长和医生如何做出关于抗生素的决策,以及肥胖的潜在相关风险是否会改变这些决策,我们对照顾儿童的家长和医生进行了一项定性研究。家长焦点小组和医生访谈采用了一份指南,该指南聚焦于抗生素使用经验以及对包括肥胖在内的风险和益处的认知。采用内容分析法来了解肥胖风险如何影响抗生素决策。大多数家长(n = 59)和医生(n = 22)报告称,在开具抗生素处方时,关于任何风险的讨论都很有限。对于急性疾病,大多数家长将症状改善放在首位,并选择开始使用抗生素。医生的治疗偏好各不相同。肥胖风险并未改变大多数家长或医生的偏好。鉴于急性疾病发生时家长与医生之间的讨论不太可能改变偏好,公共卫生宣传可能是应对肥胖和抗生素过度使用的更有效方法。

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