中国基层医疗保健环境中急性支气管炎的门诊处方模式。
Outpatient prescribing pattern for acute bronchitis in primary healthcare settings in China.
机构信息
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
出版信息
NPJ Prim Care Respir Med. 2021 May 10;31(1):24. doi: 10.1038/s41533-021-00234-y.
Inappropriate prescribing for acute bronchitis in primary healthcare settings (PHSs) is commonly seen worldwide. Here we describe the prescribing patterns and antibiotic use for acute bronchitis in PHSs across China. We conduct a nationwide cross-sectional survey to collect outpatient prescriptions from PHSs in 2017. Patients diagnosed with acute bronchitis without other infections are eligible for this study. Generalized estimating equations are used for analysis. Overall, 10,678 prescriptions for acute bronchitis from 214 institutions are included. The antibiotic prescription rate is 44.5% for total prescriptions, and differs significantly by region and urban/rural status (p < 0.05). Among all single-antibiotic prescriptions, 91.5% are broad-spectrum. Two-thirds of the prescriptions contain medicines for symptom management. The overall guideline compliance rate of acute bronchitis treatment for adults is 31.0%. Prescribing antibiotics, especially broad-spectrum ones, for acute bronchitis is commonly observed in Chinese PHSs. Targeted interventions are urgently needed for Chinese primary clinicians, especially in western rural areas.
在基层医疗机构（PHS）中，急性支气管炎的不适当处方在全球范围内都很常见。在这里，我们描述了中国 PHS 中急性支气管炎的处方模式和抗生素使用情况。我们进行了一项全国性的横断面调查，以收集 2017 年 PHS 的门诊处方。本研究纳入了无其他感染的急性支气管炎患者。采用广义估计方程进行分析。总体而言，共纳入了来自 214 家机构的 10678 份急性支气管炎处方。抗生素处方率占总处方的 44.5%，且在地区和城乡状况方面差异显著（p < 0.05）。在所有单一抗生素处方中，91.5%为广谱抗生素。三分之二的处方含有对症治疗药物。成人急性支气管炎治疗的总体指南依从率为 31.0%。在中国 PHS 中，经常会出现针对急性支气管炎开具抗生素，特别是广谱抗生素的情况。中国基层临床医生，特别是西部农村地区的医生，急需进行有针对性的干预。
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