Antibiotics and paediatric acute respiratory infections in rural Vietnam: health-care providers' knowledge, practical competence and reported practice
Antibiotics and paediatric acute respiratory infections in rural Vietnam: health-care providers' knowledge, practical competence and reported practice
复制标题
DOI：
10.1111/j.1365-3156.2009.02267.x
复制
发表时间：
2009-05-01
影响因子：
3.3
通讯作者：
Stalsby, Cecilia Lundborg
中科院分区：
文献类型：
--
作者：
Hoa, Nguyen Quynh;Larson, Mattias;Stalsby, Cecilia Lundborg
目的评估卫生保健提供者关于使用抗生素治疗越南农村五岁以下儿童急性呼吸道感染的知识、实践能力和报告的做法。方法为儿童开或配西药的卫生保健提供者自行填写结构化调查问卷。世卫组织关于抗生素使用的建议和国家指南用于评估报告的急性呼吸道感染治疗的适当性。结果 409 名符合条件的医疗保健提供者中有 96% 参与了研究。只有 27% 的人表现出对抵抗后果的正确认识。 79% 的人会在发烧的普通感冒中使用抗生素，21% 的人会在不发烧的情况下使用抗生素。 19% 的总体知识符合建议的指南。书面描述的普通感冒抗生素使用情况（81%）与非转诊肺炎病例（87%）没有显着差异。在拥有正确整体知识的医疗保健提供者中，在普通感冒情况下使用抗生素的比例明显较低。根据最近接触病童的症状报告，所见疾病为轻度急性呼吸道感染，19%为重症，19%为非呼吸道感染。其中，抗生素（最常见的是 β-内酰胺类）的使用率分别为 90%、87% 和 78%。结论 抗生素经常被处方或配发来治疗普通感冒。应与地方和国家儿科医生合作制定和实施改变处方和配药做法的干预措施。对医疗保健提供者（尤其是药品销售者）的持续培训非常重要。
ObjectiveTo assess knowledge, practical competence and reported practices among health‐care providers about antibiotics to treat acute respiratory infections in children under five in rural Vietnam.MethodHealth‐care providers prescribing or dispensing western drugs for children self‐completed a structured questionnaire. Recommendations concerning antibiotic use from WHO and national guidelines were used to assess the appropriateness of reported treatment of acute respiratory infections.ResultsNinety‐six per cent of 409 eligible health care providers participated. Only 27% demonstrated correct knowledge regarding the consequences of resistance. Seventy‐nine per cent would use antibiotics for common colds with fever, and 21% in cases with no fever. Nineteen per cent had overall knowledge compliant with recommended guidelines. Stated antibiotic use in written scenarios for common colds (81%) was not significantly different from that for non‐referral cases of pneumonia (87%). The proportion of antibiotic use in the common cold scenario was significantly lower among health‐care providers who had the correct overall knowledge. According to reported symptoms from the most recent encounter with a sick child, the diseases seen were 62% mild acute respiratory infections, 19% severe, and 19% non‐respiratory infections. Among those, antibiotics, most commonly beta‐lactams, were used in 90%, 87% and 78% of cases, respectively.ConclusionsAntibiotics are often prescribed or dispensed to treat common colds. Interventions to change prescribing and dispensing practices should be developed and implemented in collaboration with local and national paediatricians. Continuous training of health‐care providers, particularly drug sellers, is important.