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澳大利亚北部地区三个偏远社区的原住民儿童抗生素使用情况。

Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.

机构信息

Child Health, Menzies School of Health Research, Darwin, Northern Territory, Australia.

Child Health, Sunrise Health Service Aboriginal Corporation, Katherine, Northern Territory, Australia.

出版信息

PLoS One. 2020 Apr 17;15(4):e0231798. doi: 10.1371/journal.pone.0231798. eCollection 2020.

Abstract

OBJECTIVE

To describe antibiotic prescription rates for Australian Aboriginal children aged <2 years living in three remote Northern Territory communities.

DESIGN

A retrospective cohort study using electronic health records.

SETTING

Three primary health care centres located in the Katherine East region.

PARTICIPANTS

Consent was obtained from 149 mothers to extract data from 196 child records. There were 124 children born between January 2010 and July 2014 who resided in one of the three chosen communities and had electronic health records for their first two years of life.

MAIN OUTCOME MEASURES

Antibiotic prescription rates, factors associated with antibiotic prescription and factors associated with appropriate antibiotic prescription.

RESULTS

There were 5,675 Primary Health Care (PHC) encounters for 124 children (median 41, IQR 25.5, 64). Of the 5,675 PHC encounters, 1,542 (27%) recorded at least one infection (total 1,777) and 1,330 (23%) had at least one antibiotic prescription recorded (total 1,468). Children had a median five (IQR 2, 9) prescriptions in both their first and second year of life, with a prescription rate of 5.99/person year (95% CI 5.35, 6.63). Acute otitis media was the most common infection (683 records, 38%) and Amoxycillin was the most commonly prescribed antibiotic (797 prescriptions, 54%). Of the 1,468 recorded prescriptions, 398 (27%) had no infection recorded and 116 (8%) with an infection recorded were not aligned with local treatment guidelines.

CONCLUSION

Prescription rates for Australian Aboriginal children in these communities are significantly higher than that reported nationally for non-Aboriginal Australians. Prescriptions predominantly aligned with treatment guidelines in this setting where there is a high burden of infectious disease.

摘要

目的

描述居住在北领地三个偏远社区的<2 岁澳大利亚原住民儿童的抗生素处方率。

设计

使用电子健康记录的回顾性队列研究。

地点

位于凯瑟琳东部地区的三个初级保健中心。

参与者

征得 149 位母亲的同意,从 196 名儿童记录中提取数据。共有 124 名儿童于 2010 年 1 月至 2014 年 7 月在三个选定社区之一出生,且他们在前两年有电子健康记录。

主要观察指标

抗生素处方率、与抗生素处方相关的因素以及与适当抗生素处方相关的因素。

结果

124 名儿童共有 5675 次初级保健(PHC)就诊(中位数 41 岁,IQR25.5 岁,64 岁)。在 5675 次 PHC 就诊中,有 1542 次(27%)记录了至少一种感染(总计 1777 次),有 1330 次(23%)记录了至少一种抗生素处方(总计 1468 次)。儿童在其第一和第二年的中位数各有 5 次(IQR2 次,9 次)处方,其处方率为 5.99/人年(95%CI5.35,6.63)。急性中耳炎是最常见的感染(683 次记录,38%),阿莫西林是最常用的处方抗生素(797 次处方,54%)。在 1468 次记录的处方中,有 398 次(27%)无感染记录,有 116 次(8%)有感染记录但与当地治疗指南不符。

结论

这些社区中澳大利亚原住民儿童的处方率明显高于全国非原住民澳大利亚人的报告率。在感染性疾病负担较高的情况下,这些处方主要与该地区的治疗指南一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a141/7164616/51c5ec618e1b/pone.0231798.g001.jpg

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