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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Provider and practice characteristics associated with antibiotic use in children with presumed viral respiratory tract infections.
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Provider and practice characteristics associated with antibiotic use in children with presumed viral respiratory tract infections.

机译：推定病毒性呼吸道感染儿童的抗生素使用相关提供者和实践特征。

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OBJECTIVE: Although overuse of antibiotics in children has been well documented, relatively little information is known about provider and facility characteristics associated with this prescribing practice. This study was done to evaluate the differences in overuse of antibiotics among staff physicians and resident/interns (housestaff [HS]) who work in hospital-based outpatient clinics. METHODS: This cross-sectional study involved patient encounters in outpatient departments that were included in the US National Hospital Ambulatory Medical Care Survey database from 1995 to 2000. Encounters with patients who were aged <18 years and had a primary diagnosis suggestive of viral respiratory tract infection were evaluated. Patients with comorbid conditions that might justify antibiotic use were excluded. RESULTS: This study included 1952 patient encounters with a primary diagnosis suggestive of a viral infection and 33.2% of these patients receiving antibiotics. Overall, antibiotic use was significantly lessamong HS (19.5%) than staff physicians (36.4%; odds ratio [OR]: 0.44; 95% confidence interval [CI]: 0.33-0.59). This difference between HS (19.5%) and staff physicians (32.5%) persisted even within teaching hospitals (OR: 0.5; 95% CI: 0.4-0.7). Among staff physicians, antibiotic use was greater among those who work in nonteaching (39.6%) compared with teaching hospitals (32.5%; OR: 1.51; 95%: CI 1.15-1.98). Controlling for other patient and provider variables, antibiotic use occurred less among HS than among staff physicians in teaching hospitals (OR: 0.53; 95% CI: 0.38-0.75). CONCLUSIONS: Antibiotic prescribing in the context of an outpatient visit for a diagnosis suggestive of a viral respiratory tract illness occurs more commonly among staff physicians than trainees and among staff physicians more commonly in nonteaching compared with teaching institutions.
机译：目的：尽管已有充分的文献证明儿童过量使用抗生素，但与这种处方实践有关的提供者和设施特征的信息知之甚少。这项研究旨在评估在医院门诊诊所工作的医师和住院医师/实习生之间过度使用抗生素的差异。方法：这项横断面研究涉及1995年至2000年美国国家医院门诊医疗调查数据库中所包含的门诊患者遭遇情况。遇到年龄小于18岁且主要诊断为病毒性呼吸道的患者评估感染。排除可能合并抗生素的合并症患者。结果：该研究包括1952例初次诊断为病毒感染的患者，其中33.2％的患者接受了抗生素治疗。总体而言，抗生素的使用率在HS（19.5％）上明显低于在职医生（36.4％;优势比[OR]：0.44; 95％置信区间[CI]：0.33-0.59）。即使在教学医院内，HS（19.5％）和医务人员（32.5％）之间的差异仍然存在（OR：0.5; 95％CI：0.4-0.7）。在教职医生中，与教学医院（32.5％; OR：1.51; 95％：CI 1.15-1.98）相比，在非教学工作者中使用抗生素的比例更高（39.6％）。通过控制其他患者和提供者变量，HS的抗生素使用率少于教学医院的参谋医生（OR：0.53; 95％CI：0.38-0.75）。结论：与教学机构相比，在门诊就诊的情况下，与实习生相比，在职医师中比在受训者中更常见于抗生素医师，而在非教学中，在医师中更常见于抗生素。

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