Zhang J, Cameron D, Quak S H, Kadim M, Mohan N, Ryoo E, Sandhu B, Yamashiro Y, Guarino A, Hoekstra H
The Children's Hospital, School of Medicine, Zhejiang University, 3333 Binsheng Road, 310052 Hangzhou, Zhejiang, China P.R.
Royal Children's Hospital Melbourne, Department of Gastroenterology, 50 Flemington Road, 3052 Parkville, Australia.
Benef Microbes. 2020 Aug 12;11(4):329-338. doi: 10.3920/BM2019.0203. Epub 2020 Jun 8.
Antibiotic therapy may have important side effects. Guidelines recommend the administration of specific probiotics to reduce the risk of antibiotic-associated diarrhoea (AAD). The rates and determinants of antibiotics and co-prescription of probiotics in children remain poorly known in Asia-Pacific countries, which are very heterogenous in terms of economic development, health care organization and health policies. A survey among general practitioners (GPs) and paediatricians was performed in seven countries of the Asia-Pacific area (Australia, Japan, Indonesia, India, China, Singapore, and South Korea). Physicians completed an online questionnaire that explored their current habits and the determinants for prescribing antibiotics and probiotics. For the 731 physicians who completed the questionnaire (390 paediatricians and 341 GPs), 37% of all consultations for a child led to the prescription of antibiotics (ranging from 17% in Australia to 47% in India). A large majority of physicians (84%) agreed that antibiotics disrupted gut microbiota and considered probiotics an effective intervention to prevent AAD (68%). However, only 33% co-prescribed probiotics with antibiotics (ranging from 13% in Japan to 60% in South Korea). The main reasons for prescribing probiotics were previous episodes of AAD (61%), presence of diarrhoea (55%), prolonged antibiotic treatment (54%) or amoxicillin-clavulanic acid therapy (54%). Although current local guidelines recommend the use of selected probiotics in children receiving antibiotics in Asia-Pacific area, the rates of antibiotics and probiotics prescription significantly vary among countries and are deeply affected by country-related cultural and organisational issues.
抗生素治疗可能会产生重要的副作用。指南建议使用特定的益生菌来降低抗生素相关性腹泻（AAD）的风险。在亚太国家，儿童抗生素使用及益生菌联合处方的比例和决定因素仍鲜为人知，这些国家在经济发展、医疗保健组织和卫生政策方面差异很大。在亚太地区的七个国家（澳大利亚、日本、印度尼西亚、印度、中国、新加坡和韩国）对全科医生（GP）和儿科医生进行了一项调查。医生们完成了一份在线问卷，该问卷探讨了他们目前的习惯以及开具抗生素和益生菌处方的决定因素。对于完成问卷的731名医生（390名儿科医生和341名全科医生）而言，所有儿童会诊中有37%导致了抗生素处方（范围从澳大利亚的17%到印度的47%）。绝大多数医生（84%）同意抗生素会破坏肠道微生物群，并认为益生菌是预防AAD的有效干预措施（68%）。然而，只有33%的医生将益生菌与抗生素联合处方（范围从日本的13%到韩国的60%）。开具益生菌的主要原因是既往有AAD发作（61%）、存在腹泻（55%）、长期抗生素治疗（54%）或阿莫西林 - 克拉维酸治疗（54%）。尽管目前当地指南建议在亚太地区接受抗生素治疗的儿童中使用特定的益生菌，但抗生素和益生菌的处方率在各国之间存在显著差异，并深受与国家相关的文化和组织问题的影响。
