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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >National ambulatory antibiotic prescribing patterns for pediatric urinary tract infection, 1998-2007.
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National ambulatory antibiotic prescribing patterns for pediatric urinary tract infection, 1998-2007.

机译：1998-2007年，全国小儿尿路感染的门诊抗生素处方模式。

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OBJECTIVE: The goal of this study was to investigate patterns of ambulatory antibiotic use and to identify factors associated with broad-spectrum antibiotic prescribing for pediatric urinary tract infections (UTIs). METHODS: We examined antibiotics prescribed for UTIs for children aged younger than 18 years from 1998 to 2007 using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Amoxicillin-clavulanate, quinolones, macrolides, and second- and third-generation cephalosporins were classified as broad-spectrum antibiotics. We evaluated trends in broad-spectrum antibiotic prescribing patterns and performed multivariable logistic regression to identify factors associated with broad-spectrum antibiotic use. RESULTS: Antibiotics were prescribed for 70% of pediatric UTI visits. Trimethoprim-sulfamethoxazole was the most commonly prescribed antibiotic (49% of visits). Broad-spectrum antibiotics were prescribed one third of the time. There was no increase in overall use of broad-spectrum antibiotics (P = .67); however, third-generation cephalosporin use doubled from 12% to 25% (P = .02). Children younger than 2 years old (odds ratio: 6.4 [95% confidence interval: 2.2-18.7, compared with children 13-17 years old]), females (odds ratio: 3.6 [95% confidence interval: 1.6-8.5]), and temperature >/= 100.4 degrees F (odds ratio: 2.9 [95% confidence interval: 1.0-8.6]) were independent predictors of broad-spectrum antibiotic prescribing. Race, physician specialty, region, and insurance status were not associated with antibiotic selection. CONCLUSIONS: Ambulatory care physicians commonly prescribe broad-spectrum antibiotics for the treatment of pediatric UTIs, especially for febrile infants in whom complicated infections are more likely. The doubling in use of third-generation cephalosporins suggests that opportunities exist to promote more judicious antibiotic prescribing because most pediatric UTIs are susceptible to narrower alternatives.
机译：目的：本研究的目的是调查门诊使用抗生素的方式，并确定与广谱抗生素处方有关的小儿尿路感染（UTIs）的相关因素。方法：我们使用“国家门诊医疗调查”和“国家医院门诊医疗调查”，对1998年至2007年未满18岁儿童的UTI处方抗生素进行了检查。克拉莫酸阿莫西林，喹诺酮类，大环内酯类药物以及第二代和第三代头孢菌素被归类为广谱抗生素。我们评估了广谱抗生素处方模式的趋势，并进行了多变量logistic回归分析，以确定与广谱抗生素使用相关的因素。结果：70％的小儿UTI就诊均使用了抗生素。甲氧苄氨嘧啶磺胺甲基异恶唑是最常用的抗生素（占就诊次数的49％）。三分之一的时间开了广谱抗生素。广谱抗生素的总体使用没有增加（P = .67）;但是，第三代头孢菌素的使用率从12％翻了一番，达到25％（P = .02）。 2岁以下的儿童（比值：6.4 [95％置信区间：2.2-18.7，与13-17岁的儿童相比]，女性（比值：3.6 [95％的置信区间：1.6-8.5]），温度> / = 100.4华氏度（比值：2.9 [95％置信区间：1.0-8.6]）是广谱抗生素处方的独立预测因素。种族，医师专长，地区和保险状况与选择抗生素无关。结论：门诊医生通常开处方广谱抗生素来治疗小儿UTI，特别是对于那些可能发生复杂感染的高热婴儿。第三代头孢菌素的使用量增加了一倍，这表明存在促进更明智的抗生素处方的机会，因为大多数儿科UTI都可以使用较窄的替代品。

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