对患有喉痛的儿童进行抗生素治疗
Jeffrey A Linder1, David W Bates, Grace M Lee
1Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. jlinder@partners.org
JAMA
|November 10, 2005
概括
对喉疼痛儿童的抗生素处方仍然很高,超过了A组β-溶血性链球菌 (GABHS) 的患病率. 虽然GABHS测试可以在特定情况下减少抗生素的使用,但它在儿科护理中未得到充分利用.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 临床实践指南 临床实践指南
背景情况:
- 甲组β-溶血性链球菌 (GABHS) 导致15-36%的儿科喉痛.
- 在处方抗生素之前对儿童进行GABHS测试,建议儿童患有喉炎.
- 建议用于GABHS的抗生素包括青素,阿莫西西林,红红素和第一代胞素.
研究的目的:
- 测量患有喉疼痛的儿童的抗生素处方和GABHS测试率.
- 评估GABHS测试与抗生素治疗决策之间的关联.
主要方法:
- 从国家门诊医疗保健调查和国家医院门诊医疗保健调查 (1995-2003) 的数据分析.
- 包括3至17岁的喉疼痛儿童的访问.
- 检查了抗生素处方,推/不推的抗生素使用和GABHS测试的全国率.
主要成果:
- 在每年730万次喉痛诊所中,有53%的患者被处方了抗生素.
- 在接受抗生素治疗的儿童中,27%的儿童服用了非推的抗生素.
- 在53%的访问中进行了GABHS测试,并且与特定诊断 (喉炎,桃体炎,链球菌喉炎) 的抗生素处方率较低有关.
结论:
- 针对儿科喉痛的抗生素处方超过了GABHS预期的流行率.
- 从1995年到2003年,抗生素处方的减少是由于减少了推药物的使用.
- 尽管它与某些儿科病例的抗生素处方减少有关,但GABHS测试仍未得到充分利用.
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