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健康儿童上呼吸道感染的转归:急性上呼吸道感染治疗中的抗生素管理

Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections.

作者信息

Khan Ejaz Ahmed, Raja Mazhar Hussain, Chaudhry Shehla, Zahra Tehreem, Naeem Salman, Anwar Masuma

机构信息

Ejaz Ahmed Khan, MBBS, MD. Department of Pediatrics, Shifa International Hospital Ltd, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

Mazhar Hussain Raja, MRCP, MRCPC. Department of Pediatrics, Shifa International Hospital Ltd, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

出版信息

Pak J Med Sci. 2020 May-Jun;36(4):642-646. doi: 10.12669/pjms.36.4.1420.

Abstract

OBJECTIVE

The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children.

METHODS

This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient's demographics, clinical features, laboratory data and outcome were recorded. Follow up phone calls were made to parents on day 7 (response 93.6%) and day 14 (response 94.6%) to record outcome.

RESULTS

A total of 314 children with URTIs were included. Majority (57.6%) were males and <1year of age (40%). Common manifestations of URTI were fever (89%), cough (79%), rhinorrhoea (62%), pharyngitis (79%) and conjunctivitis (46%). More than half (53%) had history of contact with URTI in a family member. Mean duration of symptoms was 2.7±1.3 days. Majority (93%) of children were given supportive treatment and only 6.7% received antibiotics initially. Most of children (76%) recovered within one week and 91.8% within two weeks with supportive care only. Only 4% children were hospitalized and 12% required follow up visit of which 16% needed oral antibiotics. Complications or deaths did not occur.

CONCLUSIONS

Majority of URTIs in healthy children resolved with supportive treatment and do not require antibiotics. Antibiotic stewardship in simple URTIs should be practiced using awareness and advocacy campaigns.

摘要

目的

本研究的目的是评估健康儿童上呼吸道感染(URTI)的转归情况。

方法

本描述性研究对314名3至36个月大的儿童进行,这些儿童在儿科门诊和急诊科出现URTI症状(发热、咳嗽、流涕)≤5天。记录患者的人口统计学资料、临床特征、实验室数据及转归情况。在第7天(应答率93.6%)和第14天(应答率94.6%)给家长打电话以记录转归情况。

结果

共纳入314例URTI患儿。大多数(57.6%)为男性,年龄<1岁(40%)。URTI的常见表现为发热(89%)、咳嗽(79%)、流涕(62%)、咽炎(79%)和结膜炎(46%)。超过一半(53%)的患儿有家庭成员患URTI的接触史。症状的平均持续时间为2.7±1.3天。大多数(93%)患儿接受了支持治疗,仅6.7%的患儿最初接受了抗生素治疗。大多数患儿(76%)在一周内康复,仅通过支持治疗91.8%的患儿在两周内康复。仅4%的患儿住院,12%的患儿需要随访,其中16%需要口服抗生素。未发生并发症或死亡。

结论

健康儿童的大多数URTI通过支持治疗即可痊愈,无需使用抗生素。对于简单的URTI,应通过提高认识和开展宣传活动来实施抗生素管理。

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