Discipline of Paediatrics and Adolescent Medicine, Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia.
Da Nang Hospital for Women and Children, Da Nang, Vietnam.
J Paediatr Child Health. 2019 Nov;55(11):1329-1334. doi: 10.1111/jpc.14413. Epub 2019 Feb 17.
To characterise paediatricians' antibiotic-prescribing behaviour when managing community acquired pneumonia.
We conducted a knowledge and attitudes survey of paediatric doctors practicing at a regional provincial hospital in central Vietnam over a 2-week period (from 12 December 2017 to 29 December 2017).
Of 79 eligible paediatric doctors, 69 (87.3%) completed the questionnaire, of whom 65 (94.2%) thought that antibiotics were overused in Vietnam. Thirty-eight doctors (55.1%) indicated that they routinely hospitalised children with pneumonia to provide intravenous antibiotics. Most doctors reported discharging children with non-severe pneumonia after 5 days (76.9%) and those with severe pneumonia after 7-10 days (88.4%); older doctors generally continued intravenous antibiotics for longer. The two most important factors driving discharge decisions were clinical assessment (95.6%) and completion of the full course of intravenous antibiotics (80.0%). Antibiotic prescription was influenced by local guidelines (62.3%), drugs used before admission (50.0%) and the opinion of senior clinicians (37.7%). Most doctors believed antibiotic stewardship was necessary (98.6%) and that over-the-counter use of antibiotics should be restricted (97.1%).
Paediatricians recognised an urgent need for more effective regulation and antibiotic stewardship in Vietnam. Routinely completing a full course of intravenous antibiotics leads to unnecessary and prolonged hospitalisation.
描述儿科医生在管理社区获得性肺炎时的抗生素处方行为。
我们对越南中部一家地区省级医院的儿科医生进行了为期两周的知识和态度调查（2017 年 12 月 12 日至 12 月 29 日）。
在 79 名符合条件的儿科医生中，有 69 名（87.3%）完成了问卷，其中 65 名（94.2%）认为越南抗生素使用过度。38 名医生（55.1%）表示他们通常会将患有肺炎的儿童住院接受静脉注射抗生素治疗。大多数医生报告说，5 天后（76.9%）会让非重症肺炎患儿出院，7-10 天后（88.4%）会让重症肺炎患儿出院；年长的医生通常会让静脉注射抗生素治疗时间更长。决定出院的两个最重要因素是临床评估（95.6%）和静脉注射抗生素的完整疗程（80.0%）。抗生素的处方受到当地指南（62.3%）、入院前使用的药物（50.0%）和资深临床医生的意见（37.7%）的影响。大多数医生认为抗生素管理是必要的（98.6%），应该限制抗生素的非处方使用（97.1%）。
儿科医生认识到越南迫切需要更有效的监管和抗生素管理。常规完成完整的静脉注射抗生素疗程会导致不必要的和延长的住院时间。
