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首页> 外文期刊>Annals of Clinical Microbiology and Antimicrobials >Physician behaviour for antimicrobial prescribing for paediatric upper respiratory tract infections: a survey in general practice in Trinidad, West Indies
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Physician behaviour for antimicrobial prescribing for paediatric upper respiratory tract infections: a survey in general practice in Trinidad, West Indies

机译：儿科上呼吸道感染的抗菌药物处方医师行为：西印度群岛特立尼达的一项常规调查

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Background Upper respiratory tract infections (URTIs) are among the most frequent reasons for physician office visits in paediatrics. Despite their predominant viral aetiology, URTIs continue to be treated with antimicrobials. We explored general practitioners' (GPs) prescribing behaviour for antimicrobials in children (≤ 16 years) with URTIs in Trinidad, using the guidelines from the Centers for Disease Control and Prevention (CDC) as a reference. Methods A cross-sectional study was conducted on 92 consenting GPs from the 109 contacted in Central and East Trinidad, between January to June 2003. Using a pilot-tested questionnaire, GPs identified the 5 most frequent URTIs they see in office and reported on their antimicrobial prescribing practices for these URTIs to trained research students. Results The 5 most frequent URTIs presenting in children in general practice, are the common cold, pharyngitis, tonsillitis, sinusitis and acute otitis media (AOM) in rank order. GPs prescribe at least 25 different antibiotics for these URTIs with significant associations for amoxicillin, co-amoxiclav, cefaclor, cefuroxime, erythromycin, clarithromycin and azithromycin (p 30 years were more likely to prescribe antibiotics for the common cold (p = 0.014). Severity (95.7%) and duration of illness (82.5%) influenced doctors' prescribing and over prescribing in general practice was attributed to parent demands (75%) and concern for secondary bacterial infections (70%). Physicians do not request laboratory investigations primarily because they are unnecessary (86%) and the waiting time for results is too long (51%). Conclusions Antibiotics are over prescribed for paediatric URTIs in Trinidad and amoxicillin with co-amoxiclav were preferentially prescribed. Except for AOM, GPs' prescribing varied from the CDC guidelines for drug and duration. Physicians recognise antibiotics are overused and consider parents expecting antibiotics and a concern for secondary bacterial infections are prescribing pressures. Guidelines to manage URTIs, ongoing surveillance programs for antibiotic resistance, public health education on non-antibiotic strategies, and postgraduate education for rational pharmacotherapy in general practice would decrease inappropriate antibiotic use in URTIs.
机译：背景技术上呼吸道感染（URTIs）是儿科医师就诊的最常见原因之一。尽管病毒病原学占主导地位，但URTIs仍继续使用抗微生物药治疗。我们使用疾病控制与预防中心（CDC）的指南，探讨了特立尼达的URTI患儿（≤16岁）的全科医生（GPs）处方行为。方法在2003年1月至6月间，对特立尼达中部和东部的109名接触者中的92名同意的全科医生进行了横断面研究。通过试点测试问卷，全科医生确定了他们在办公室见到的5个最常见的URTI，并报告了他们这些URTI对受过训练的研究学生的抗菌处方操作。结果在一般情况下，儿童中出现的5种最常见的URTI是感冒，咽炎，扁桃体炎，鼻窦炎和急性中耳炎（AOM）。 GP对这些URTI至少开出25种不同的抗生素，并与阿莫西林，阿莫西拉夫，头孢克洛，头孢呋辛，红霉素，克拉霉素和阿奇霉素有显着关联（p 30年更有可能为普通感冒开出抗生素（p = 0.014）。 （95.7％）和疾病持续时间（82.5％）影响了医生的处方，一般情况下处方过量是由于父母的要求（75％）和对继发性细菌感染的担忧（70％）。医生不要求进行实验室检查的主要原因是结论：特立尼达的儿科URTIs的抗生素使用量超标，而阿莫西林与阿莫西拉夫的处方则优先使用;除AOM外，GP的处方方法各不相同（86％），且等待结果的时间过长（51％）。 CDC的药物使用时间和疗程指南。医师认识到抗生素已被过度使用，并考虑父母期望使用抗生素，并担心继发细菌感染正在规定压力。管理URTI的指南，正在进行的抗生素耐药性监测计划，关于非抗生素策略的公共卫生教育以及一般实践中合理药物治疗的研究生教育，将减少URTI中不当使用抗生素的情况。

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