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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Race, otitis media, and antibiotic selection
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Race, otitis media, and antibiotic selection

机译：种族，中耳炎和抗生素选择

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BACKGROUND AND OBJECTIVE: Previous research suggests that physicians may be less likely to diagnose otitis media (OM) and to prescribe broad-spectrum antibiotics for black versus nonblack children. Our objective was to determine whether race is associated with differences in OM diagnosis and antibiotic prescribing nationally. METHODS: We examined OM visit rates during 2008 to 2010 for children ≤14 years old using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. We compared OM visits between black and nonblack children, as percentages of all outpatient visits and visit rates per 1000. We compared antibiotic prescribing by race as the percentage of OM visits receiving narrowspectrum (eg, amoxicillin) versus broader-spectrum antibiotics. We used multivariable logistic regression to examine whether race was independently associated with antibiotic selection for OM. RESULTS: The percentage of all visits resulting in OM diagnosis was 30% lower in black children compared with others (7% vs 10%, P = .004). However, OM visits per 1000 population were not different between black and nonblack children (253 vs 321, P = .12). When diagnosed with OM during visits in which antibiotics were prescribed, black children were less likely to receive broad-spectrum antibiotics than nonblack children (42% vs 52%, P = .01). In multivariable analysis, black race was negatively associated with broad-spectrum antibiotic prescribing (adjusted odds ratio 0.59; 95% confidence interval, 0.40-0.86). CONCLUSIONS: Differences in treatment choice for black children with OM may indicate race-based differences in physician practice patterns and parental preferences for children with OM.
机译：背景与目的：先前的研究表明，医师可能不太可能诊断中耳炎（OM）和开辟针对黑人与非黑人儿童的广谱抗生素。我们的目标是确定种族是否与全国OM诊断和抗生素处方的差异有关。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2008年至2010年≤14岁的儿童的OM访问率进行了检查。我们比较了黑人和非黑人儿童之间的OM访视，占所有门诊就诊的百分比和每千人的就诊率。我们比较了按种族开出的抗生素处方与接受窄谱（例如阿莫西林）与广谱抗生素的OM访视的百分比。我们使用多变量logistic回归分析种族是否与OM的抗生素选择独立相关。结果：与其他人相比，黑人儿童中所有导致OM诊断的访视百分比降低了30％（7％对10％，P = .004）。但是，黑人和非黑人儿童每千人口的OM访视没有差异（253比321，P = 0.12）。在开处方抗生素的就诊期间被诊断为OM时，与非黑人孩子相比，黑人孩子接受广谱抗生素的可能性较小（42％比52％，P = 0.01）。在多变量分析中，黑人种族与广谱抗生素处方呈负相关（调整后的优势比为0.59; 95％置信区间为0.40-0.86）。结论：黑人患有OM的儿童在治疗选择上的差异可能表明基于种族的医师实践模式和OM患儿的父母偏好存在差异。

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