Children With Acute Upper Respiratory Tract Infection Outpatient Antibiotic Use Survey

.Acute upper respiratory tract infection (AURI) clinically referred to as the flu,is the most common pediatric respiratory infectious diseases, the incidence rate ofabout60%of pediatric outpatients[1]. Acute upper respiratory infections in differentparts due to infection, clinical manifestations vary. Some data indicate that the flumore than90%of the primary pathogen is a virus, there are adenovirus, rhinovirus,parainfluenza virus, respiratory syncytial virus, etc.[2]. However, due to the uniquepediatric respiratory system organ features a very short time at the onset, it ispossible bacterial infection. Therefore, how to use antibiotics and when to useantibiotics, so that both can be effective in treating children with upper respiratorytract infection, it will not lead to resistant bacteria, is the focus of attention in recentyears[2]. Meanwhile, in recent years a large number of medical studies, theapplication of antibiotics there are certain risk factors. Therefore, how to strengthenthe supervision of pediatric antibiotic use, through an objective evaluation of theirusage, and promote the rational use of antibiotics without delay[3-4]. To understandthe Third Affiliated Hospital of Zhengzhou University, outpatient pediatric acuteupper respiratory tract infections in children with rational use of antibiotics, In theThird Affiliated Hospital of Zhengzhou University pediatric clinic cases, randomlyselected (2012.01-2013.01) only diagnosed with acute upper respiratory tract infection in children and prescription cases were retrospectively analyzed.PurposeCollected in the Third Affiliated Hospital of Zhengzhou University pediatricclinic admitted with acute upper respiratory tract infections in children, the statisticsof its antibiotic application, analysis of antibiotics in the pediatric patient with acuteupper respiratory tract infection in children normative applied to further rationalapplication of antibiotics aspects of in-depth analysis, hope for rational use ofantibiotics for the pediatric clinic to provide valuable assistance.Materials and methods1．Materials CollectionRandomly selected from Zheng Dasan establishing affiliated hospital outpatientdoctor workstation in January2012to January2013in the pediatric clinic, the onlychildren diagnosed as acute upper respiratory tract infection of outpatient cases, atotal of1012cases, incomplete removal of complications and hospitalization receivedata of91cases, include cases of921cases, diagnostic met diagnostic criteria for theJuly edition of the ZhuFuTang practical pediatrics. Among them,494cases of male,female427cases. Age-February14, the average age of2.8years old. In all patients,the general types of acute upper respiratory tract infection in772cases,126cases ofacute suppurative tonsillitis, herpangina23cases.2．results2.1pharmacological decision criteriaReference "new pharmacology"[17]and the China pharmacopoeia (2010edition),according to the WHO’s advice, drug utilization degree (DUI) was used as diagnosticcriteria. Limit daily dose (DDD) refers to a particular drug for treatment of a majorsymptoms, the average daily dose for adults. Children’s daily dose limit refers to aparticular drug treatment specific indications of unit weight daily dose. In frequency(DDDs) as the drugs within a certain period of time the total purchase amount dividedby the corresponding DDD values, is to measure the drug use frequency. Drugutilization index (DUI) as the DDDs divided by the total number of days. Children’s drug use index (CDUI) refers to the unit weight is obtained by dividing the total doselimit children daily dose, and the ratio of number of days, namely the DDDs/totalnumber of days. If DUI1or less for rational drug use.2.2clinical decision criteriaThe determination of reasonable use of antibiotics: every white blood cell isunusual for antibiotics should be used; Use of penicillin, the new green Ⅱ, cefazolincommon antibiotics for rational use of antibiotics, such as white blood cells andnormal use of antibiotics, with more than the second generation cephalosporins or usenew broad-spectrum penicillin, combination treatment with two or more antibioticsare not reasonable use of antibiotics, in which two or more broad spectrum antibioticsapplication is judged to be indiscriminate use of antibiotics.Bear fruit1. The general clinical analysisFever,874patients with normal number47cases; Routine blood and shown aneleated total (>10x109/L) and (or) with an increase in neutrophils (>70%) in512cases, total white blood cells (<4x109/L)21cases,388cases of normal bloodpicture.2. The antibiotic useIn the921cases,738cases of application of antibiotics, antibiotic utilization rateof80.13%.Of772cases of general type of acute upper respiratory tract infection,589cases ofapplication of antibiotics, antibiotic usage by76.30%,397cases of oral antibioticsaccounted for67.40%, with penicillin class (amoxicillin clavulanic acid potassium),second and third generation of cephalosporin antibiotics (cefaclor, cefixime), and alarge ring lactone class (azithromycin); Intravenous application of single antibiotic174cases, accounting for29.54%, with the second generation cephalosporin class ofantibiotics (cefoxitin, cefmetazole); Two antibiotics,8cases, accounted for1.36%, with the second generation cephalosporins joint large ring lactone class antibioticcefoxitin or cefmetazole azithromycin.In126cases of children with suppurative tonsillitis, total intravenous antibiotics,with three generations of cephalosporins antibiotics (ceftriaxone) and threegenerations of cephalosporins with enzyme inhibitors (cefoperazone shu ba temple).In23cases of children with herpangina, full use of antibiotics, including4cases oforal antibiotics,19cases of application of single antibiotic, give priority to with thesecond generation cephalosporins.3. The antibiotic usage analysisIn921cases,738cases of children with use of antibiotics, antibiotic utilizationrate was80.13%, and the utilization rate of oral antibiotics accounted for54.34%,utilization rate (45.66%), intravenous antibiotics were used three kinds of antibiotics,cephalosporin class of the most widely used, the penicillin class times, large ringlactone class was third.Conclusion1. Children with early onset of acute upper respiratory tract infection, mostly viralinfections, anti-virus and should be given symptomatic and supportive treatment, andoutpatient acute upper respiratory tract infection in the early use of antibiotics existsirrationality.2. Incidence of acute respiratory infections easily after48-72h bacterial infection,clinical manifestations and inflammatory markers may help determine bacterialinfection, support plus antibiotics.