全国多地区儿童社区获得性肺炎住院患儿抗菌药物使用情况分析  

Status of antibiotic use in hospitalized children with community-acquired pneumonia in multiple regions of China

作　　者：魏巍[1] 王雪峰[2] 刘建平[3] 申昆玲[4] 马融[5] 崔振泽[6] 邓力 李燕宁[8] 姜之炎[9] 许华[10] 王力宁[11] 冯晓纯[12] 吴振起[2] 刘兆兰[3] 黄燕[6] 何春卉 刘华[10] 赵雪[2] 王子[2] 郝欧美[2] WEI Wei;WANG Xue-Feng;LIU Jian-Ping;SHEN Kun-Ling;MA Rong;CUI Zhen-Ze;DENG Li;LI Yan-Ning;JIANG Zhi-Yan;XU Hua;WANG Li-Ning;FENG Xiao-Chun;WU Zhen-Qi;LIU Zhao-Lan;HUANG Yan;HE Chun-Hui;LIU Hua;ZHAO Xue;WANG Zi;HAO Ou-Mei(First Clinical Medical Institute, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China)

机构地区：[1]辽宁中医药大学第一临床学院,辽宁沈阳110032 [2]辽宁中医药大学附属医院儿科,辽宁沈阳110032 [3]北京中医药大学循证医学中心,北京100029 [4]首都医科大学附属北京儿童医院呼吸内科,北京110045 [5]天津中医药大学第一附属医院儿科,天津300193 [6]大连医科大学附属儿童医院呼吸科,辽宁大连116012 [7]广州市妇女儿童医疗中心呼吸科,广东广州510623 [8]山东中医药大学附属医院儿科,山东济南250011 [9]上海中医药大学附属龙华医院儿科,上海200032 [10]广州中医药大学第一附属医院儿科,广东广州510405 [11]广西中医学院第一附属医院儿科,广西南宁530012 [12]长春中医药大学附属医院儿科,吉林长春130103

出　　处：《中国当代儿科杂志》2019年第1期11-17,共7页Chinese Journal of Contemporary Pediatrics

基　　金：国家"十二五"中医药科研行业专项项目(JDZX2015030);国家自然科学基金(81273800;81373687)

摘　　要：目的统计全国多地区儿童社区获得性肺炎(CAP)抗菌药物的使用情况,为进一步加强儿童CAP的规范治疗及抗菌药物合理使用提供参考依据。方法统计2014年4月14日至2016年1月1日全国9个城市10家三甲医院儿科住院的1 383例CAP患儿的抗菌药物使用情况,分析华北、东北、华东、华南4个区域住院患儿的抗菌药物使用情况。结果 CAP患儿抗菌药物总使用率为89.08%,其中华北88.7%,东北95.5%,华东83.3%,华南86.6%。使用种类主要为头孢类、大环内酯类、β内酰胺类抗菌药物的复方制剂、多磷类广谱抗菌药物、其他β内酰胺类抗菌药物。抗菌药物的选用基本合理,但仍存在单纯病毒感染时使用抗菌药物、单纯感染时联用抗菌药物等现象;抗菌药物的不合理应用例数共有131例,不合理使用率为10.63%。结论儿童CAP抗菌药物使用率、不合理用药率偏高,应加强对儿童CAP抗菌药物使用的规范化管理。Objective To investigate the use of antibiotics in children with community-acquired pneumonia (CAP) in multiple regions of China, and to provide a reference for CAP standard treatment and rational antibiotic use in children. Methods The medical data of 1383 children with CAP who were hospitalized in the department of pediatrics in 10 grade A tertiary hospitals from 9 cities between April 14, 2014 and January 1, 2016 were reviewed, to analyze the status of antibiotic use in hospitalized children in North China, Northeast China, East China, and South China. Results The overall rate of antibiotic use in children with CAP was 89.08%, with 88.7% in North China, 95.5% in Northeast China, 83.3% in East China, and 86.6% in South China. The main types of antibiotics used were cephalosporins, macrolides, compound preparations of β-lactam antibiotics, polyphosphoric broad-spectrum antibiotics and other β-lactam antibiotics. The selection of antibiotics was generally rational, but antibiotics were still used in some patients with viral infection alone or a combined use of ≥ 2 kinds of antibiotics were noted in some patients with infection caused by one kind of pathogen. Irrational antibiotic use was observed in 131 children (10.63%). Conclusions There are high rates of antibiotic use and irrational use of antibiotics among children with CAP. Standard management of antibiotic use in children with CAP should be strengthened.

关 键 词：社区获得性肺炎 抗菌药物 儿童 

分 类 号：R725.6[医药卫生—儿科]