Fong Ivy, Zhu Jingqin, Finkelstein Yaron, To Teresa
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
ICES, Toronto, ON, Canada.
ERJ Open Res. 2021 Mar 15;7(1). doi: 10.1183/23120541.00944-2020. eCollection 2021 Jan.
Antibiotics are among the most common medications dispensed to children and youths. The objective of this study was to characterise and compare antibiotic use patterns between children and youths with and without asthma.
We conducted a population-based nested case-control study using health administrative data from Ontario, Canada, in 2018. All Ontario residents aged 5-24 years with asthma were included as cases. Cases were matched to controls with a 1:1 ratio based on age (within 0.5 year), sex and location of residence. Multivariable conditional logistic regression was used to obtain an odds ratio and 95% confidence interval for having filled at least one antibiotic prescription, adjusted for socioeconomic status, rurality, and presence of common infections, allergic conditions and complex chronic conditions.
The study population included 1 174 424 Ontario children and youths aged 5-24 years. 31% of individuals with asthma and 23% of individuals without asthma filled at least one antibiotic prescription. The odds of having filled at least one antibiotic prescription were 34% higher among individuals with asthma compared to those without asthma (OR 1.34, 95% CI 1.32-1.35). In the stratified analysis, the odds ratios were highest in the youngest group of children studied, aged 5-9 years (OR 1.45, 95% CI 1.41-1.48), and in females (OR 1.36, 95% CI 1.34-1.38).
Asthma is significantly associated with increased antibiotic use in children and youths. This association is the strongest in younger children and in females.
抗生素是给儿童和青少年使用最为普遍的药物之一。本研究的目的是描述和比较患哮喘与未患哮喘的儿童和青少年的抗生素使用模式。
我们利用2018年加拿大安大略省的卫生行政数据进行了一项基于人群的巢式病例对照研究。所有年龄在5至24岁的安大略省哮喘患者被纳入病例组。根据年龄（相差不超过0.5岁）、性别和居住地点，病例与对照组按1:1的比例进行匹配。使用多变量条件逻辑回归来获得至少开具过一张抗生素处方的比值比及95%置信区间，并对社会经济状况、农村地区以及是否存在常见感染、过敏状况和复杂慢性病进行了调整。
研究人群包括1174424名年龄在5至24岁的安大略省儿童和青少年。31%的哮喘患者和23%的非哮喘患者至少开具过一张抗生素处方。与非哮喘患者相比，哮喘患者开具至少一张抗生素处方的几率高出34%（比值比1.34，95%置信区间1.32 - 1.35）。在分层分析中，比值比在研究中最年幼的儿童组（5至9岁）中最高（比值比1.45，95%置信区间1.41 - 1.48），在女性中也较高（比值比1.36，95%置信区间1.34 - 1.38）。
哮喘与儿童和青少年抗生素使用增加显著相关。这种关联在年幼儿童和女性中最为明显。
