在肯尼亚西部和沿海的门诊处方抗生素的模式
Melanie Kiener1, Caroline Ichura2, Bryson A Ndenga3
1Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America.
PLOS global public health
|January 3, 2025
概括
肯尼亚诊所的抗生素处方量很高,特别是针对儿童和非细菌性疾病. 这种过度使用有助于抗菌素耐药性,需要更好的诊断和管理计划.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗菌素耐药性 (AMR) 是一个主要的全球健康威胁,由抗菌素的过度使用和滥用驱动.
- 识别抗生素处方的驱动因素对于打击抗菌素耐药性至关重要,特别是在低收入和中等收入国家.
研究的目的:
- 确定与肯尼亚门诊处方抗生素处方相关的因素.
- 评估与诊断和患者人口统计相关的抗生素处方模式.
主要方法:
- 在肯尼亚西部和沿海地区 (1,526次门诊访问) 的回顾性,描述性队列研究 (2019年12月-2022年2月).
- 数据包括患者的人口统计,症状,体检,临床医生的评估,实验室结果 (疟疾RDT,登革热RT-qPCR) 和处方.
- 多变量逻辑回归确定了与抗生素处方相关的因素.
主要成果:
- 总体而言,抗生素在73%的遭遇中被处方,而在5岁以下的儿童中,抗生素被处方的比例为84%.
- 近一半 (48%) 的抗生素处方是在没有临时细菌诊断的情况下发布的.
- 增加处方几率的因素包括:西肯尼亚诊所,年龄≤18,心肺呼吸系统症状,阴性疟疾RDT和潜在的细菌诊断.
结论:
- 肯尼亚诊所的抗生素处方率很高,通常用于非细菌性疾病,有助于AMR.
- 抗生素处方率,特别是对儿童的处方率,比以前的队列增加了.
- 加强诊断和抗菌药物管理计划对于优化抗生素使用至关重要.
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