儿童呼吸道感染抗生素治疗效果的观察性研究——基层医疗实践中的研究

Outcomes of antibiotic treatment for respiratory infections in children an observational study in primary care.

机构信息

Department of Medicine, University of Bergen, Bergen, Norway.

Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.

出版信息

Scand J Prim Health Care. 2024 Jun;42(2):237-245. doi: 10.1080/02813432.2024.2305929. Epub 2024 Jan 24.

Abstract

BACKGROUND

Antibiotic resistance is an increasing global threat, accelerated by both misuse and overuse of antibiotics. Most antibiotics to humans are prescribed in primary care, commonly for respiratory symptoms, and there is a need for research on the usage of and outcomes after antibiotic treatment to counteract antibiotic resistance.

OBJECTIVE

To evaluate symptom duration, treatment length, and adverse events of antibiotic treatment in children.

DESIGN AND SETTING

Observational study at four out-of-hours services and one paediatric emergency clinic in Norwegian emergency primary care.

SUBJECTS

266 children aged 0 to 6 years with fever or respiratory symptoms.

MAIN OUTCOME MEASURES

Duration of symptoms and absenteeism from kindergarten/school, treatment length, and reported adverse events.

RESULTS

There were no differences in duration of symptoms, fever or absenteeism when comparing the groups prescribed (30.8%) and not prescribed (69.2%) antibiotics. This lack of difference remained when analysing the subgroup with otitis media.In the group prescribed antibiotics, 84.5% of parents reported giving antibiotics for 5-7 days, and 50.7% reported no difficulties. Adverse events of antibiotics were reported in 42.3% of the cases, the vast majority being gastrointestinal disturbances.

CONCLUSION

Children with fever or respiratory symptoms experience similar duration of symptoms and absenteeism regardless of antibiotic treatment. A substantial number of parents reported adverse events when the child received antibiotics. Several parents experienced additional difficulties with the treatment, some ending treatment within day 4.

TRIAL REGISTRATION NUMBER

NCT02496559; Results.

摘要

背景

抗生素耐药性是一个日益严重的全球威胁,这是由于抗生素的滥用和过度使用所加速的。大多数抗生素都是在初级保健中开给人类的,通常用于治疗呼吸道症状,因此需要研究抗生素治疗的使用情况和治疗结果,以对抗抗生素耐药性。

目的

评估儿童使用抗生素治疗的症状持续时间、治疗时长和不良事件。

设计和设置

在挪威急诊初级保健的四个夜间门诊和一个儿科急诊诊所进行的观察性研究。

受试者

266 名 0 至 6 岁发热或有呼吸道症状的儿童。

主要观察指标

症状持续时间和因病缺勤时间(从幼儿园/学校)、治疗时长和报告的不良事件。

结果

在比较开具(30.8%)和未开具(69.2%)抗生素的两组儿童中,症状持续时间、发热或缺勤时间没有差异。在中耳炎亚组分析中也存在同样的结果。在开具抗生素的组中,84.5%的家长报告给孩子服用抗生素 5-7 天,50.7%的家长报告没有困难。报告了 42.3%的抗生素不良事件,绝大多数为胃肠道紊乱。

结论

无论是否接受抗生素治疗,发热或呼吸道症状的儿童症状持续时间和缺勤时间相似。相当多的父母报告说孩子在服用抗生素后出现了不良事件。一些父母在治疗过程中遇到了额外的困难,有些父母在第 4 天内停止了治疗。

试验注册号

NCT02496559;结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3660/11003315/b93eba81ba31/IPRI_A_2305929_F0001_B.jpg

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