Krishnan Sankaran, Ianotti Vicki, Welter John, Gallagher Meighan Maye, Ndjatou Tatiana, Dozor Allen J
New York Medical College, Valhalla, NY, USA.
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
Glob Pediatr Health. 2019 Feb 25;6:2333794X19831296. doi: 10.1177/2333794X19831296. eCollection 2019.
Real-world management decisions for acute cough in children in primary care practice are not well understood. This study is an analysis of 560 encounters for children with cough, 19 days to 18 years of age, seen in a predominantly suburban academic pediatric practice, over 1 year. Past history, cough duration, and cough characteristics significantly affected treatment decisions. Children with cough frequently had a history of preterm birth, allergies, asthma, and neurological conditions. Most common therapies were bronchodilators, antibiotics, and oral corticosteroids. Children prescribed antibiotics were older, more likely to have a wet or productive cough, history of sinusitis, pneumonia or dysphagia, and longer cough duration. Children prescribed oral corticosteroids were younger, less likely to be wet or productive and more likely to have history of asthma or dysphagia. Children prescribed bronchodilators were more likely to have fever, nasal congestion, and wheezing and history of previous asthma, pneumonia, or dysphagia.
基层医疗实践中儿童急性咳嗽的实际管理决策尚不清楚。本研究分析了在一所主要位于郊区的学术性儿科诊所一年多时间里诊治的560例19天至18岁咳嗽儿童的病例。既往史、咳嗽持续时间和咳嗽特征对治疗决策有显著影响。咳嗽儿童常有早产、过敏、哮喘和神经系统疾病史。最常用的治疗方法是支气管扩张剂、抗生素和口服糖皮质激素。使用抗生素的儿童年龄较大,更可能有湿性或有痰咳嗽、鼻窦炎、肺炎或吞咽困难病史,咳嗽持续时间更长。使用口服糖皮质激素的儿童年龄较小,不太可能有湿性或有痰咳嗽,更可能有哮喘或吞咽困难病史。使用支气管扩张剂的儿童更可能有发热、鼻塞、喘息以及既往哮喘、肺炎或吞咽困难病史。