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首页> 外文期刊>Scandinavian journal of primary health care. >Primary care management of respiratory tract infections in Dutch preschool children.
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Primary care management of respiratory tract infections in Dutch preschool children.

机译：荷兰学龄前儿童呼吸道感染的初级保健管理。

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OBJECTIVE: To determine age-specific antibiotic prescription and referral rates in preschool children diagnosed with acute respiratory tract infection (RTI) in primary care. DESIGN: Retrospective cohort study. SETTING: Research database of the Netherlands University Medical Center Utrecht Primary Care Network. SUBJECTS: All children aged 0-5 years within the database were included, covering 1998 to 2002 (18,801 child-years). MAIN OUTCOME MEASURES: Antibiotic prescription and referral rates were determined as percentage of children with at least one prescription or referral within a year, as total number of prescriptions per 1000 child-years, and as percentage of all RTI episodes. RESULTS: Antibiotics, mostly beta-lactam (80%) and macrolides (16%), were prescribed in 35% of RTI episodes. Annually 13% of the children received at least one antibiotic following an RTI. Antibiotics were prescribed in more than half of episodes of LRTI, sinusitis, AOM, and acute tonsillitis, and in 12-15% of episodes of asthma exacerbation, acute laryngitis, influenza acute, and acute upper respiratory infection (including common cold and pharyngitis). Almost 98% of RTIs were managed in primary care. On average 1% of the children were referred to a paediatrician or ENT specialist following RTI per year, especially after AOM (59% of referrals). Compared with older children, those under two years of age were more often treated with antibiotics (relative risk [RR] 1.4, 95% CI 1.3-1.6) and referred (RR 2.3; 95% CI 1.8-3.0). CONCLUSION: In the Netherlands most episodes of RTIs in preschool children were managed in primary care and this often involves prescription of antibiotics. Children younger than two years of age receive more often antibiotics for RTI and are also referred more, especially for AOM.
机译：目的：确定在初级保健中诊断为急性呼吸道感染（RTI）的学龄前儿童的年龄特定抗生素处方和转诊率。设计：回顾性队列研究。地点：荷兰大学医疗中心乌得勒支初级保健网络的研究数据库。研究对象：数据库中所有0-5岁的儿童，涵盖了1998年至2002年（18,801个儿童年）。主要观察指标：抗生素处方和转诊率是根据一年内至少接受一次处方或转诊的儿童所占的百分比，每千个儿童年内处方的总数以及所有RTI发作的百分比来确定的。结果：35％的RTI发作中开了抗生素，主要是β-内酰胺（80％）和大环内酯类（16％）。每年有13％的儿童在RTI后接受至少一种抗生素。在LRTI，鼻窦炎，AOM和急性扁桃体炎的发作中，以及在哮喘发作，急性喉炎，急性流感和急性上呼吸道感染（包括普通感冒和咽喉炎）的发作中，有超过12-15％的患者开了抗生素。几乎98％的RTI在基层医疗中得到管理。每年RTI后，尤其是在AOM之后，平均有1％的儿童被转诊到儿科医生或耳鼻喉专科医生（占转诊的59％）。与年龄较大的儿童相比，两岁以下的儿童更常接受抗生素治疗（相对危险度[RR] 1.4，95％CI 1.3-1.6）并转诊（RR 2.3; 95％CI 1.8-3.0）。结论：在荷兰，学龄前儿童的大多数RTI发作均在初级保健中进行管理，这通常涉及抗生素处方。两岁以下的儿童接受RTI抗生素治疗的频率更高，尤其是针对AOM的治疗，其推荐率也更高。

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