Korppi Matti
Centre for Child Health Research, Faculty of Medicine and Life Sciences, University of Tampere and University Hospital, Tampere, Finland.
Acta Paediatr. 2022 Aug;111(8):1500-1506. doi: 10.1111/apa.16381. Epub 2022 May 8.
This mini review summarises the available data on antibiotic stewardship programmes (ASP) for acute respiratory tract infections (ARTI) in paediatric outpatients, particularly the implementation and impact of programmes.
PubMed was searched from 1 January 2012 to 31 December 2021 for papers with abstracts that used the terms respiratory tract infection, antibiotic, child and guideline. We then saw how many of these included the individual terms impact, implementation or stewardship. After exclusions, we included 10 papers that were published in English on children treated as outpatients for ARTIs. All of these included data on implementing and assessing the impact of ASPs.
The primary care data were mainly from the United States. The ASP programmes did not influence antibiotic prescription rates, but broad-spectrum antibiotics decreased by 43-48%. The emergency department data were mainly from France and the antibiotic prescription rate decreased by 31-35% and the rate for broad-spectrum antibiotics by 63-71%. A nationwide register-based study from France confirmed these results.
ASPs had a low impact on overall antibiotic prescription rates and a modest impact on prescribing broad-spectrum antibiotics. The implementation of ASP protocols needs further development, and more research is necessary on barriers to complying with ASPs.
本综述总结了有关儿科门诊急性呼吸道感染（ARTI）抗生素管理计划（ASP）的现有数据，特别是这些计划的实施情况和影响。
检索2012年1月1日至2021年12月31日期间PubMed上带有摘要的论文，这些摘要使用了“呼吸道感染”“抗生素”“儿童”和“指南”等术语。然后查看其中有多少篇包含“影响”“实施”或“管理”这些单独的术语。排除相关论文后，我们纳入了10篇以英文发表的关于儿科门诊ARTI患者的论文。所有这些论文都包含了关于实施和评估ASP影响的数据。
初级保健数据主要来自美国。ASP计划并未影响抗生素处方率，但广谱抗生素的使用减少了43%-48%。急诊科数据主要来自法国，抗生素处方率下降了31%-35%，广谱抗生素的使用率下降了63%-71%。法国一项基于全国登记的研究证实了这些结果。
ASP对总体抗生素处方率影响较小，对广谱抗生素处方的影响适中。ASP方案的实施需要进一步发展，并且有必要对遵守ASP的障碍进行更多研究。
