Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Division of Paediatric Infectious Diseases, Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Paediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Int J Infect Dis. 2021 Jan;102:369-374. doi: 10.1016/j.ijid.2020.10.105. Epub 2020 Nov 10.
Antibiotics are frequently prescribed for the treatment of acute lower respiratory infections (ALRI) in children ≤5 years of age, even though viral aetiologies are the most common. The aim of this study was to describe antibiotic prescribing rates and patterns in children ≤5 years of age hospitalized with ALRI.
A retrospective study was conducted involving patients aged 1 month to 5 years hospitalized with ALRI at a university hospital. Patient demographics, ALRI diagnosis, microbiological data, antibiotics prescribed, and treatment outcomes were recorded and analysed.
A total of 1283 patients were enrolled. Their median age was 1.6 years (interquartile range 0.8-2.8 years). Thirty-six percent had a co-morbidity. The diagnosis at discharge was viral ALRI in 81% and bacterial pneumonia in 19%. The mortality rate was 0.4%. The overall antibiotic prescribing rate was 46% (95% confidence interval 43-49%). Antibiotic prescribing rates were higher among children with co-morbidities (65% vs 35%, p < 0.001) and older children (57% for >2-5 years vs 39% for ≤2 years, p < 0.001). Parenteral third-generation cephalosporins were prescribed in up to 68% of all prescriptions.
Nearly-half of hospitalized children with ALRI were prescribed antibiotics. The majority of prescribed antibiotics were third-generation cephalosporins. An antimicrobial stewardship programme and antibiotic guidelines should be implemented to promote the judicious use of antibiotics.
抗生素常被用于治疗≤5 岁儿童的急性下呼吸道感染（ALRI），尽管病毒病因最为常见。本研究旨在描述≤5 岁因 ALRI 住院的儿童抗生素的开具率和模式。
对一家大学医院因 ALRI 住院的 1 个月至 5 岁患儿进行回顾性研究。记录并分析患者的人口统计学特征、ALRI 诊断、微生物学数据、开具的抗生素以及治疗结局。
共纳入 1283 例患儿。其中位年龄为 1.6 岁（四分位间距 0.8-2.8 岁）。36%的患儿合并有合并症。出院诊断为病毒性 ALRI 占 81%，细菌性肺炎占 19%。死亡率为 0.4%。总体抗生素开具率为 46%（95%置信区间 43-49%）。合并症患儿（65%比 35%，p<0.001）和大龄儿童（>2-5 岁组 57%比≤2 岁组 39%，p<0.001）抗生素开具率更高。所有处方中，有高达 68%的患儿开具了第三代头孢菌素类药物。
近一半因 ALRI 住院的患儿开具了抗生素。所开抗生素中大多数为第三代头孢菌素类药物。应实施抗菌药物管理项目和抗生素指南，以促进抗生素的合理使用。
