The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Murdoch Children's Research Institute, University of Melbourne. Royal Children's Hospital, Parkville, Australia.
J Infect Dev Ctries. 2020 Feb 29;14(2):129-137. doi: 10.3855/jidc.11938.
Antimicrobial resistance is a global health crisis and primarily caused by antibiotic misuse. Antibiotic misuse among children is particularly concerning, and its prevalence may vary from region to region in China with different development levels.
Zhejiang and Shaanxi were selected to represent developed and less developed provinces in China, respectively. Data of 2924 parents in Zhejiang and 3355 parents in Shaanxi whose children were 0-13 years old were collected through multi-stage stratified cluster random sampling and a self-administrated questionnaire. Chi-square tests and logistic regression models were used for statistical analysis.
Compared to parents in Zhejiang, those in Shaanxi were more likely to keep antibiotics for children at home, to engage in self-medication with antibiotics for children, and to make their children take antibiotics prophylactically. While there were no significant provincial differences between parents' requests for antibiotics during pediatric consultations, parents in Shaanxi province were more likely to receive prescribed antibiotics.
Children in less developed provinces face higher risks of antibiotic misuse at home as well as when attending medical practitioners. Comprehensive educational interventions are required to improve antibiotic use for children all over China but particularly in less developed provinces such as Shaanxi. Furthermore, non-prescription sales and over-prescribing of antibiotics should be reduced by targeted strategies.
抗生素耐药性是一个全球性的健康危机，主要是由于抗生素的滥用。儿童中抗生素的滥用尤其令人担忧，而且在中国，由于不同地区的发展水平不同，其流行情况可能有所不同。
选择浙江和陕西分别代表中国发达和欠发达的省份。通过多阶段分层聚类随机抽样和自填式问卷，收集了浙江 2924 名家长和陕西 3355 名 0-13 岁儿童家长的数据。采用卡方检验和逻辑回归模型进行统计分析。
与浙江的家长相比，陕西的家长更有可能为孩子在家中储备抗生素，自行给孩子使用抗生素进行治疗，以及让孩子预防性使用抗生素。虽然家长在儿科就诊时要求开抗生素的情况在两省之间没有显著差异，但陕西的家长更有可能获得处方抗生素。
欠发达省份的儿童在家中以及在看医生时面临更高的抗生素滥用风险。需要在全国范围内开展全面的教育干预措施，以改善儿童的抗生素使用情况，但在陕西等欠发达省份尤为如此。此外，应通过有针对性的策略减少抗生素的非处方销售和过度处方。
