Frank Tyler A, Oosthuizen Frasia, Bangalee Varsha
Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Health SA. 2023 Dec 20;28:2464. doi: 10.4102/hsag.v28i0.2464. eCollection 2023.
The World Health Organization (WHO) guidelines recommend the empiric treatment of infections before definitive treatment begins. However, ethical concerns limit the availability of clinical trials in neonates and paediatrics to fully ascertain the safety profile of antibiotics in these populations.
This study aimed to quantify the use of antibiotics among neonates and paediatrics and commented on the use, rationale and appropriateness of antibiotics prescribed.
A secondary level public sector hospital located in Durban, KwaZulu-Natal.
Demographic and treatment information of neonates and paediatrics were collected retrospectively from January 2022 to June 2022. Data were obtained from patient files and extracted for analysis using Microsoft Excel. Analytical and descriptive statistics were used to analyse patient demographics and treatment variables.
A total of 568 antibiotics, issued to 389 patients, were reviewed. Penicillins (40.1%), aminoglycosides (24.3%) and combination penicillin-beta-lactam inhibitors (23.3%) were identified as the most frequently prescribed antibiotics for inpatients. Most antibiotics prescribed to inpatients were for complications associated with pre-term birth (66.9%). Combination penicillin-beta-lactam inhibitors (34.7%), penicillins (29.5%) and cephalosporins (29.5%) were the most frequently prescribed antibiotics to outpatients. A correlation was found between the route of administration and the duration of therapy; the intravenous route (63.6%) was preferred over the oral route (36.4%) for administration.
Many broad-spectrum antibiotics were prescribed, thus increasing the risk of resistance. Antibiotics were being prescribed according to the guidelines; however, there is still a need for therapeutic drug monitoring to ensure the continuation of rational drug use.
There was evidence of rational use of antibiotics in the public hospital (KwaZulu-Natal), in keeping with economic and availability factors.
世界卫生组织（WHO）指南建议在开始确定性治疗之前对感染进行经验性治疗。然而，伦理问题限制了新生儿和儿科临床试验的开展，无法充分确定这些人群中抗生素的安全性。
本研究旨在量化新生儿和儿科患者抗生素的使用情况，并对所开具抗生素的使用、理由及合理性进行评价。
位于夸祖鲁-纳塔尔省德班的一家二级公立部门医院。
回顾性收集2022年1月至2022年6月期间新生儿和儿科患者的人口统计学和治疗信息。数据从患者病历中获取，并使用Microsoft Excel提取进行分析。采用分析性和描述性统计方法分析患者人口统计学和治疗变量。
共审查了发放给389名患者的568份抗生素处方。青霉素（40.1%）、氨基糖苷类（24.3%）和青霉素-β-内酰胺酶抑制剂联合制剂（23.3%）被确定为住院患者最常开具的抗生素。开具给住院患者的大多数抗生素用于治疗与早产相关的并发症（66.9%）。联合青霉素-β-内酰胺酶抑制剂（34.7%）、青霉素（29.5%）和头孢菌素（29.5%）是门诊患者最常开具的抗生素。发现给药途径与治疗持续时间之间存在相关性；静脉给药途径（63.6%）比口服给药途径（36.4%）更受青睐。
开具了许多广谱抗生素，从而增加了耐药风险。抗生素的开具符合指南要求；然而，仍需要进行治疗药物监测以确保合理用药的持续进行。
有证据表明，这家公立医院（夸祖鲁-纳塔尔省）在使用抗生素方面是合理的，符合经济和可获得性因素。
