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首页> 外文期刊>Patient Preference and Adherence >Prospective study on the overuse of blood test-guided antibiotics on patients with acute diarrhea in primary hospitals of China
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Prospective study on the overuse of blood test-guided antibiotics on patients with acute diarrhea in primary hospitals of China

机译：中国基层医院过度使用血液检测指导抗生素治疗急性腹泻的前瞻性研究

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Background: Overuse with antibiotics in the treatment of infectious diseases has become a central focus of public health over the years. The aim of this study was to provide an up-to-date evaluation of the blood test-guided antibiotic use on patients with acute diarrhea in primary hospitals of China. Materials and methods: A cross-sectional survey was conducted on 330 patients with acute diarrhea in Shanghai, People’s Republic of China, from March 2013 to February 2016. These patients were treated with or without antibiotics based on the results of their blood tests, including examinations of C-reactive protein (CRP), white blood cells (WBC), and the percentage of neutrophils (Neu%). The infection types, which included bacterial, viral, and combination diarrhea, were determined by microbiological culture methods. Antibiotics used in non-bacterial diarrhea patients were considered misused and overused. Results: There were significant overall differences in the clinical characteristics and blood tests between patients with diarrhea with a bacterial infection and patients with other types of infections. The patients were divided into four grading groups (0–3) according to the number of the positive results from three blood testes (CRP, WBC, and Neu%). The misuse rates of antibiotics in each group (0–3) were 81.3%, 71.1%, 72.4%, and 64.9%, respectively. Conclusion: In this prospective study, the current diagnostic criteria (CRP, WBC, and Neu%) based on blood tests are not reliable in diagnosing bacterial diarrhea or guiding antibiotics use. To limit antibiotic overuse, a rapid and accurate differentiation of bacterial diarrhea from other types of diarrhea is pivotal.
机译：背景：多年来，过度使用抗生素治疗传染病已成为公共卫生的重点。这项研究的目的是对中国基层医院急性腹泻患者的血液测试指导的抗生素使用情况进行最新评估。材料和方法：2013年3月至2016年2月，在中国上海市对330例急性腹泻患者进行了横断面调查。根据他们的血液检查结果，这些患者接受或不接受抗生素治疗，包括检查C反应蛋白（CRP），白细胞（WBC）和中性粒细胞百分比（Neu％）。通过微生物培养方法确定感染类型，包括细菌性，病毒性和组合性腹泻。非细菌性腹泻患者使用的抗生素被认为滥用和滥用。结果：细菌感染的腹泻患者和其他类型的感染患者在临床特征和血液检查方面存在显着的总体差异。根据来自三个血液睾丸（CRP，WBC和Neu％）的阳性结果的数量，将患者分为四个等级组（0–3）。每组（0–3）的抗生素误用率分别为81.3％，71.1％，72.4％和64.9％。结论：在这项前瞻性研究中，基于血液测试的当前诊断标准（CRP，WBC和Neu％）在诊断细菌性腹泻或指导抗生素使用方面并不可靠。为了限制抗生素的过度使用，细菌性腹泻与其他类型的腹泻的快速，准确区分至关重要。

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