社区获得的儿科耳炎的抗生素管理:干预前后的研究
Maayan Diti Machnes1, Herman Avner Cohen1, Maya Gerstein1
1Pediatric Ambulatory Community Clinic, Petach Tikva, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Israel Medical Association journal : IMAJ
|July 18, 2023
概括
一个抗生素管理计划 (ASP) 略有减少了对儿科A组链球菌 (GAS) 喉炎的不必要的抗生素处方. 该计划改善了检测,但没有改变抗生素选择或减少广谱使用.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 甲型链球菌 (GAS) 喉炎是儿童常见的细菌感染,通常在临床上无法与病毒性喉炎区分.
- 过度使用抗生素在儿科喉炎中很普遍,尽管病毒感染的发病率很高.
研究的目的:
- 评估抗生素管理计划 (ASP) 对儿童GAS喉炎的抗生素处方实践的影响.
- 评估ASP干预后诊断测试和抗生素选择的变化.
主要方法:
- 一个准实验性设计,比较了干预前 (2016-2017) 和干预后 (2017-2018) 期间的抗生素处方数据.
- 干预包括为儿科医生提供一天的教育研讨会,讨论GAS喉炎诊断和治疗指南.
主要成果:
- 没有接受GAS喉炎实验室检测的儿童比例下降 (68%至63%).
- 快速抗原检测测试 (28%至32%) 和喉培养 (3%至4%) 的增加.
- 处方的抗生素类型没有显著变化,包括宽谱剂和类.
结论:
- ASP导致了对GAS喉炎的诊断测试的适度改善.
- 该计划实现了对GAS喉炎的整体抗生素处方的轻微减少.
- ASP没有有效地减少广泛抗生素或宏类药物的处方.
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