Baan Esmé J, Janssens Hettie M, Kerckaert Tine, Bindels Patrick J E, de Jongste Johan C, Sturkenboom Miriam C J M, Verhamme Katia M C
Department of Medical Informatics, Erasmus University, Rotterdam, The Netherlands.
Department of Pediatric Pulmonology, Erasmus University/Sophia Children's Hospital, Rotterdam, The Netherlands.
BMJ Open. 2018 Nov 28;8(11):e022979. doi: 10.1136/bmjopen-2018-022979.
To compare the rate, indications and type of antibiotic prescriptions in children with and without asthma.
A retrospective cohort study.
Two population-based primary care databases: Integrated Primary Care Information database (IPCI; the Netherlands) and The Health Improvement Network (THIN; the UK).
Children aged 5-18 years were included from January 2000 to December 2014. A child was categorised as having asthma if there were ≥2 prescriptions of respiratory drugs in the year following a code for asthma. Children were labelled as non-asthmatic if no asthma code was recorded in the patient file.
Rate of antibiotic prescriptions, related indications and type of antibiotic drugs.
The cohorts in IPCI and THIN consisted of 946 143 and 7 241 271 person years (PY), respectively. In both cohorts, antibiotic use was significantly higher in asthmatic children (IPCI: 197vs126 users/1000 PY, THIN: 374vs250 users/1000 PY). In children with asthma, part of antibiotic prescriptions were for an asthma exacerbation only (IPCI: 14%, THIN: 4%) and prescriptions were more often due to lower respiratory tract infections then in non-asthmatic children (IPCI: 18%vs13%, THIN: 21%vs12%). Drug type and quality indicators depended more on age, gender and database than on asthma status.
Use of antibiotics was higher in asthmatic children compared with non-asthmatic children. This was mostly due to diseases for which antibiotics are normally not indicated according to guidelines. Further awareness among physicians and patients is needed to minimise antibiotic overuse and limit antibiotic resistance.
比较患哮喘和未患哮喘儿童的抗生素处方率、适应症及类型。
一项回顾性队列研究。
两个基于人群的初级保健数据库：综合初级保健信息数据库（IPCI；荷兰）和健康改善网络（THIN；英国）。
纳入2000年1月至2014年12月期间5至18岁的儿童。如果在哮喘编码后的一年中有≥2份呼吸药物处方，则该儿童被归类为患有哮喘。如果患者档案中未记录哮喘编码，则儿童被标记为非哮喘患者。
抗生素处方率、相关适应症及抗生素类型。
IPCI和THIN队列分别包含946143和7241271人年（PY）。在两个队列中，哮喘儿童的抗生素使用率均显著更高（IPCI：197对126使用者/1000 PY，THIN：374对250使用者/1000 PY）。在哮喘儿童中，部分抗生素处方仅用于哮喘加重（IPCI：14%，THIN：4%），且与非哮喘儿童相比，因下呼吸道感染导致的处方更常见（IPCI：18%对13%，THIN：21%对12%）。药物类型和质量指标更多地取决于年龄、性别和数据库，而非哮喘状态。
与非哮喘儿童相比，哮喘儿童的抗生素使用率更高。这主要是由于一些通常根据指南无需使用抗生素的疾病。需要提高医生和患者的进一步认识，以尽量减少抗生素的过度使用并限制抗生素耐药性。
