感染科门诊儿童就诊前抗菌药物使用情况及影响因素

Antibiotics Usage Before Seeing Doctor and Related Factors in Outpatients of Pediatric Infectious Diseases

目的了解某儿童医院感染科门诊就诊儿童就诊前抗菌药物使用情况及影响因素。方法对2006年12月-2007年3月感染科门诊就诊患儿的家长进行问卷调查并对与就诊前使用抗菌药物的有关因素进行分析。结果983名患儿中,72.13%(709/983)就诊前使用过抗菌药物,其中,78.56%(557/709)的抗菌药物来源于基层医疗单位;21.44%(152/709)的患儿就诊前使用抗菌药物是家长的自我医疗行为。患儿就诊前的病程(OR=3.641,95%CI:2.632～5.038),就医行为(OR=3.395,95%CI:1.688～3.399),是否发热(OR=3.395,95%CI:1.595～3.597)是就诊前使用抗菌药物的独立危险因素。结论患儿就诊前抗菌药物使用普遍,加强抗菌药物使用的宣传教育,普及基层医生和社区群众对抗菌药物使用的认识,是减少各种耐药菌株的产生和预防各种感染性疾病的重要途径。

Objective To investigate the proportion of antibiotics usage in outpatients of pediatric infectious disease before seeing a doctor and its related factors. Methods Face to face interview of children＇s parents was conducted from Dec. 2006 to Mar. 2007, descriptive analysis and Logistic regression were used to describe the proportion of antibiotics usage and explore the related factors. Results Proportion of antibiotics usage in outpatients before seeing a doctor was 72.13% （709/983）, 78.56 % parents get antibiotics from primary medical facilities, and 21.44 % parents were self- antibiotics medication. The independent risk factors of antibiotics usage were prolonged disease course （OR = 3. 641,95% CI：2. 632- 5. 038 ）, primary facilities visiting （OR ： 3. 395,95 % CI ： 1. 688 - 3. 399 ）, and fever （OR ： 3. 395,95 % CI ： 1. 595 - 3. 597 ）. Conclusion Antibiotics usage is common among outpatients of pediatric infectious disease. The strengthen health education and improve knowledge of antibiotics usage among primary practitioner and community population might be an important approach to prevent infectious disease.