Korppi Matti, Palmu Sauli, Heikkilä Paula, Csonka Péter
Centre for Child, Adolescent, and Maternal Health Research, Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
Terveystalo Healthcare, Tampere, Finland.
Acta Paediatr. 2023 May;112(5):1041-1048. doi: 10.1111/apa.16641. Epub 2022 Dec 30.
We evaluated antibiotic prescriptions issued for Finnish children with acute sinusitis by a nationwide private outpatient clinic network from 2014-2020. Data were compared before and after updated guidelines in 2018.
The study comprised data on 45 296 children aged 2-17 years with acute sinusitis, namely diagnoses, ages, dates, the doctor's specialty and any antibiotics. We measured compliance with the updated 2018 Finnish guidelines, which recommended amoxicillin or amoxicillin-clavulanic acid for children under 12 years old, with doxycycline as an alternative for 12 years plus.
There were 6621-7585 visits per year for acute sinusitis in 2014-2019 and 2954 in 2020. Antibiotics were prescribed for 37.9%-41.6% of patients during the study years. Amoxicillin, including penicillin, accounted for 35.9% of prescriptions, followed by amoxicillin-clavulanic acid (26.9%). Macrolides accounted for 20.6% and, encouragingly, decreased by 38% from 2014-2019. Doxycycline accounted for 5.3%. Paediatricians, general practitioners (GPs) and ear, nose and throat specialists followed the guidelines in 75.1%, 73.8% and 66.7% of cases, respectively. GPs prescribed antibiotics more often than other physicians.
Antibiotics were prescribed for about 40% of acute sinusitis visits by Finnish children from 2014-2019. Specialities differed with regard to prescribing rates and whether they followed the guidelines.
我们评估了2014年至2020年芬兰全国私立门诊诊所网络为患有急性鼻窦炎的儿童开具的抗生素处方。对2018年更新指南前后的数据进行了比较。
该研究纳入了45296名2至17岁患有急性鼻窦炎儿童的数据,包括诊断、年龄、日期、医生专业以及是否开具了任何抗生素。我们衡量了对2018年更新的芬兰指南的遵循情况,该指南推荐12岁以下儿童使用阿莫西林或阿莫西林-克拉维酸,12岁及以上儿童可选用多西环素作为替代。
2014年至2019年每年因急性鼻窦炎就诊6621 - 7585次,2020年为2954次。在研究期间,37.9% - 41.6%的患者被开具了抗生素。包括青霉素在内的阿莫西林占处方的35.9%,其次是阿莫西林-克拉维酸(26.9%)。大环内酯类占20.6%,令人鼓舞的是,与2014年至2019年相比下降了38%。多西环素占5.3%。儿科医生、全科医生(GP)和耳鼻喉科专家分别在75.1%、73.8%和66.7%的病例中遵循了指南。全科医生比其他医生更常开具抗生素。
2014年至2019年,芬兰约40%因急性鼻窦炎就诊的儿童被开具了抗生素。不同专业在处方率以及是否遵循指南方面存在差异。