From the Department of Pediatrics.
Department of Pediatric Allergy and Immunology.
Pediatr Emerg Care. 2021 Aug 1;37(8):407-412. doi: 10.1097/PEC.0000000000002327.
To determine the level of knowledge and practical preferences of pediatricians regarding acute urticaria (AU) management and to assess the effects of training provided in accordance with the current urticaria guideline recommendations on pediatricians who work in the pediatric emergency department (PED).
A theoretical training was provided to pediatricians regarding the diagnosis and treatment of AU in line with current urticaria guideline recommendations. Before the training, pediatricians completed a 10-item questionnaire. This prospective study assesses their treatment approaches in patients admitted to PED because of AU during the 6-month period before and the 1-year period after training.
Four hundred seventeen children in the pretraining and 1085 children in the posttraining periods were treated for AU in PED. Forty-eight pediatricians participated in the training. According to their questionnaire responses, 35% of them used only H1 antihistamine (AH) treatment, 50% used second-generation H1 AH (2nd-GAH) as AHs, 75% preferred the oral route of administration, and 85.4% did not administer systemic corticosteroid (sCS) to all patients. Comparing the practice approaches of the pediatricians in the pretraining and posttraining periods, first-generation H1 antihistamine (1st-GAH) preference rate decreased from 68.4% to 30.3% and the sCS preference rate decreased from 58.5% to 25.7%, while the 2nd-GAH preference rate increased from 31.7% to 69.7% (P < 0.001 for all). No treatments were prescribed for 10.8% of patients before the training and 3% after the training during discharge at home (P < 0.05). Comparing the home treatment choices of the pediatricians in the pretraining and posttraining periods, 1st-GAH preference rate decreased from 11.5% to 5%, while the 2nd-GAH preference rate increased from 78.7% to 91.5% (for both parameters, P < 0.001).
Practical treatment preferences of pediatricians in the treatment of children with AU differ considerably from both current guideline recommendations and their own theoretical knowledge, and training can enhance pediatricians' compliance with current guideline recommendations.
确定儿科医生对急性荨麻疹（AU）管理的知识水平和实际偏好，并评估根据当前荨麻疹指南建议对在儿科急诊部门（PED）工作的儿科医生进行培训的效果。
为儿科医生提供了关于根据当前荨麻疹指南建议诊断和治疗 AU 的理论培训。培训前，儿科医生完成了一份 10 项的调查问卷。这项前瞻性研究评估了他们在培训前 6 个月和培训后 1 年内，对因 AU 而收治在 PED 的患者的治疗方法。
在培训前的 417 名儿童和培训后的 1085 名儿童中，有 48 名儿科医生参加了培训。根据他们的问卷回答，35%的人仅使用 H1 抗组胺药（AH）治疗，50%的人使用第二代 H1 AH（2nd-GAH）作为 AHs，75%的人更喜欢口服途径，85.4%的人不会对所有患者使用全身皮质类固醇（sCS）。与培训前和培训后的儿科医生的实践方法相比，第一代 H1 抗组胺药（1st-GAH）的偏好率从 68.4%下降到 30.3%，sCS 的偏好率从 58.5%下降到 25.7%，而 2nd-GAH 的偏好率从 31.7%上升到 69.7%（均<0.001）。培训前有 10.8%的患者在出院回家时没有接受任何治疗，而培训后有 3%的患者没有接受治疗（P<0.05）。与培训前和培训后的儿科医生在家治疗的选择相比，1st-GAH 的偏好率从 11.5%下降到 5%，而 2nd-GAH 的偏好率从 78.7%上升到 91.5%（两个参数均<0.001）。
儿科医生在治疗儿童 AU 方面的实际治疗偏好与当前指南建议以及他们自己的理论知识有很大差异，培训可以提高儿科医生对当前指南建议的依从性。
