The drug use to treat community-acquired pneumonia in children

Abstract

To evaluate the rationality of drug use to treat community-acquired pneumonia (CAP) in children of a Chinese hospital using a set of developed indicators.We performed a retrospective cross-sectional study in West China Second University Hospital. Hospitalized children (0–18 years old) diagnosed with CAP from October 2015 to January 2016 were included. A set of developed indicators for assessing rational drug use (RDU) to treat CAP in children were used to evaluate the rationality of drug use. The data of the indicators were compared with the recommendations of the available guidelines, analyzing the situation of drug use in the children diagnosed with CAP.Eight hundred ninety-four children were included, 99.4% of them received antibiotics and 87.4% received more than 1 antibiotic. Antibiotics were administered intravenously in 880 (99.0%) children. About 20 (2.2%) children received antiviral agents and 19 (2.1%) children received antiviral drugs combined with antibiotics. About 208 (23.3%) children received traditional Chinese medicines and the injection of traditional Chinese medicines was given in 20 (2.2%) children.This study illustrated that drug use was partly not consistent with the recommendations of current guidelines, especially antibiotics. The drug use of CAP in children needs to pay more attention to.

Antibiotic use in children hospitalised with pneumonia in Central Vietnam

“…This suggests that a high dose of amoxicillin remains an excellent antibiotic choice in paediatric pneumonia cases. Oral antibiotics are frequently used in combination in Asian countries, with almost a third of hospitalised children receiving macrolides and cephalosporins 13 19. This is often given to cover for atypical organisms such as Mycoplasma pneumoniae , but high rates of macrolide resistance recorded in multiple settings4 suggests futility and unnecessary cost.…”

“…Our data showed that macrolide use was associated with the highest rate of oral to intravenous switch or using an ‘add-on’ oral antibiotic. Unnecessary hospitalisation and antibiotic use has also been documented in China, 13 even after confirmation of a likely viral infection,19 with intravenous cephalosporin use in >90% of cases 13…”

“…Providing 7 days of intravenous treatment essentially reflects established practice,10 although an early intravenous to oral switch policy reduces hospital stay, secondary complications and overall healthcare costs 36 37. Prolonged administration of intravenous antibiotics remains common practice in many Asian countries 13 19. An educational programme in Indonesia reduced unnecessary intravenous antibiotic use,38 but it required ongoing interaction with clinicians to sustain its impact.…”

“…Non-severe pneumonia can be managed as an outpatient with a 5-day course of oral antibiotics 10 12. Despite international recommendations and published evidence to support this approach, broad-spectrum antibiotics continue to be overprescribed,4 13 while unnecessary hospital admission and extended treatment durations impose a huge financial burden on families and healthcare systems 14–16…”

Evaluasi Luaran Klinis Terapi Antibiotik pada Pasien Community Acquired Pneumonia Anak Rawat Inap

“…Pada CAP anak penggunaan antibiotik empiris tidak dapat terhindarkan karena adanya tantangan mendiagnosis CAP secara akurat dan sulit untuk mengidentifikasi organisme penyebab 9 . Anak merupakan kelompok usia yang perlu perhatian khusus dalam pemberian obat karena perbedaan fisiologis yang dapat memengaruhi proses absorpsi, distribusi, metabolisme dan ekskresi obat serta konsentrasi obat dalam plasma atau jaringan 10,11 . Penggunaan antibiotik yang kurang tepat dapat menyebabkan resistensi bakteri.…”