A Systematic Review of Antibiotic Prescription Associated With Upper Respiratory Tract Infections in China.
A Systematic Review of Antibiotic Prescription Associated With Upper Respiratory Tract Infections in China.
复制标题
中国上呼吸道感染相关抗生素处方的系统评价
DOI：
10.1097/md.0000000000003587
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发表时间：
2016-05
期刊：
影响因子：
1.6
通讯作者：
Lu Z
中科院分区：
文献类型：
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作者：
Li J;Song X;Yang T;Chen Y;Gong Y;Yin X;Lu Z
摘要上呼吸道感染（URTI）患者抗生素滥用是一个世界性问题，在发展中国家尤其严重。本系统综述旨在总结既往关于中国URTI相关抗生素门诊处方的研究结果，以帮助政策制定者和公众了解和解决这一问题，我们系统检索并回顾了2014年12月31日之前发表的关于中国URTI门诊患者抗生素处方模式的中文或英文研究。评估研究质量，并使用随机效应模型计算上呼吸道感染病例使用抗生素的总体比例。我们进行了亚组分析，以探讨研究之间异质性的潜在来源。我们纳入了45项合格的研究，共52,072例URTI门诊患者。URTI门诊患者处方抗生素的总体百分比为83.7%（95%置信区间[CI]：80.6%-86.4%）。在使用抗生素的URTI门诊患者中，79.7%（95% CI：72.8%-85.2%）使用1种抗生素，18.4%（95% CI：13.6%-24.5%）使用2种抗生素，1.1%（95% CI：0.7%-1.6%）使用3种或3种以上抗生素。各医院抗生素处方率差异很大，且随着时间的推移呈下降趋势。中国上呼吸道感染患者中使用抗生素的比例极高，并且在低级别医院中过度使用抗生素的问题尤为严重。虽然出现了下降的趋势，这可能是由于中国最近在遏制抗生素滥用方面所做的努力，但仍需加大力度促进抗生素的合理使用。
AbstractOveruse of antibiotics among patients with upper respiratory tract infection (URTI) is a worldwide problem, and the problem is especially serious in developing countries, such as China. This systematic review is aimed at summarizing previous findings on outpatient prescriptions of antibiotics associated with URTI in China in order to help policymakers and the public understand and tackle the problem.We systematically searched and reviewed studies of antibiotic prescribing patterns for outpatients with URTI in China that were published in Chinese or English before December 31, 2014. The study quality was assessed, and the overall rates of URTI cases prescribed antibiotics were calculated by using random-effects model. Subgroup analyses were performed to explore the potential sources of heterogeneity among studies.We included 45 eligible studies with a total of 52,072 URTI outpatients. The overall percentage of URTI outpatients prescribed antibiotics was 83.7% (95% confidence interval [CI]: 80.6%–86.4%). Of the URTI outpatients prescribed antibiotics, 79.7% (95% CI: 72.8%–85.2%) were prescribed 1 antibiotic, 18.4% (95% CI: 13.6%–24.5%) prescribed 2 antibiotics, and 1.1% (95% CI: 0.7%–1.6%) prescribed 3 or more antibiotics. The rates of antibiotic prescription varied greatly across hospitals and showed a downward trend over time.An extremely high percentage of URTI patients in China were prescribed antibiotics and, the overuse is especially problematic in lower-level hospitals. Although there appears a downward trend, likely attributable to China's recent efforts in curbing antibiotic abuse, greater efforts are needed to promote the rational use of antibiotics.