南亚地区门诊急性呼吸道感染抗生素使用模式：系统评价方案。
Pattern of antibiotic use for acute respiratory infections among out-patients in South Asian Region: Protocol for a systematic review.
机构信息
Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC.
Programme for Emerging Infections, Infectious Diseases Division.
出版信息
Medicine (Baltimore). 2021 Jan 29;100(4):e22398. doi: 10.1097/MD.0000000000022398.
BACKGROUND
South Asian region has been experiencing the increasing burden of antimicrobial resistance (AMR) primarily due to over and irrational prescribing of antibiotics. Acute respiratory infections (ARIs) are the leading cause of out-patients' visits in the region. Despite commonly known viral aetiology, ARI is the single largest reason for antibiotic prescriptions contributing the exponential growth of AMR in the region. Collated data on antibiotic consumption for ARI at outpatients and resistance pattern of respiratory pathogen are lacking in the region.
METHODS
MEDLINE, Cochrane, CINAHL Plus (EBSCO), and Web of Science will be searched for eligible papers. Titles and abstracts, and full texts of the relevant studies will be screened by 2 independent reviewers against the inclusion criteria. Data extraction and quality of the studies will be assessed by 2 reviewers independently using the JBI Critical Appraisal Tools. A third reviewer will resolve any disagreement at any point between 2 reviewers.
RESULTS
The review will assess proportions of ARI patients receiving antibiotic therapy and types of antibiotics prescribed among outpatients of all ages in South Asia. This review will also assess the pattern of antimicrobial resistance among respiratory pathogens causing ARI in the region.
CONCLUSIONS
This systematic review will evaluate published literature, summarize the existing data on the antibiotic prescribing patterns for outpatients with ARI in South Asia. The holistic finding of the proportion of patients receiving antibiotic therapy for ARI, proportion of different types of antibiotic received, and resistance against respiratory pathogen might guide future research. This underscores a need for formulating regional and national policy for AMR mitigation strategy, and revising clinical practice guidelines for the clinician to ensure rational use of antibiotics for ARI.
PROSPERO
registration no: CRD42018116658.
背景
南亚地区正面临着抗菌药物耐药性（AMR）不断增加的负担，主要原因是抗生素的过度和不合理使用。急性呼吸道感染（ARI）是该地区门诊就诊的主要原因。尽管通常已知的是病毒病因，但 ARI 是抗生素处方的最大原因之一，导致该地区 AMR 的指数增长。该地区缺乏关于门诊 ARI 抗生素使用情况和呼吸道病原体耐药模式的综合数据。
方法
将在 MEDLINE、Cochrane、CINAHL Plus（EBSCO）和 Web of Science 上搜索合格论文。由 2 名独立评审员根据纳入标准筛选标题和摘要以及相关研究的全文。使用 JBI 批判性评估工具，由 2 名评审员独立评估数据提取和研究质量。在 2 名评审员之间的任何分歧点，将由第 3 名评审员解决。
结果
该综述将评估南亚所有年龄段门诊患者接受抗生素治疗的 ARI 患者比例以及开出处方的抗生素类型。该综述还将评估引起该地区 ARI 的呼吸道病原体的抗菌药物耐药模式。
结论
这项系统综述将评估已发表的文献，总结南亚门诊 ARI 患者抗生素处方模式的现有数据。接受 ARI 抗生素治疗的患者比例、接受不同类型抗生素的比例以及针对呼吸道病原体的耐药性等综合发现，可能会指导未来的研究。这突显了制定区域和国家 AMR 缓解策略的必要性，并修订临床实践指南，以确保临床医生合理使用抗生素治疗 ARI。
PROSPERO
注册号：CRD42018116658。
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