美国急诊室对患有流感的儿童的抗病毒处方的变化
Tess Stopczynski1, Olla Hamdan2, Justin Z Amarin2
1Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|October 22, 2025
概括
在COVID-19大流行期间,在急诊室 (EDs) 对高风险流感儿童的抗病毒处方显著下降. 尽管流感治疗的国家指导方针没有改变,但这种下降发生了.
科学领域:
- 儿科急救医学 儿科急救医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 国家指导方针建议对患重型流感高风险的儿童立即进行抗病毒治疗.
- 儿童急诊室 (ED) 对高风险儿童的抗病毒处方率在历史上一直低于最佳水平.
研究的目的:
- 为了比较COVID-19大流行前 (2016-2020) 和大流行后期 (2021-2023) 学术ED的高风险儿科流感患者的抗病毒处方模式.
主要方法:
- 一项多中心的横截面研究分析了来自美国7家儿科学术医院的数据.
- 包括向ED提交的流感阳性儿童 (<18岁),重点关注2016年12月至2023年6月严重流感风险较高的儿童.
- 混合效应物流回归确定了与大流行后期处方相关的因素.
主要成果:
- 在3378名流感阳性儿童中,有2514名 (74.4%) 患有高风险.
- 抗病毒处方从大流行前的32.2%下降到大流行后的15.6%,相对下降了53%.
- 较短的症状持续时间 (<2天) 和临床流感测试与大流行后期的处方有关.
结论:
- 在COVID-19大流行期间,与大流行前水平相比,ED中高风险儿童的流感抗病毒处方减少了.
- 尽管治疗指南一致,但这种下降发生了,突出显示了与指南一致的护理差距.
- 干预措施是必要的,以改善对高风险儿科流感患者的抗病毒处方建议的遵守.
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