很少有证据证明中国儿童使用抗生素的模式。我们旨在描述中国初级医疗机构(PHI)儿童的抗生素处方实践。我们描述了2017年1月至2019年12月在国家和诊断水平上为PHI儿童提供的门诊抗生素处方。利用抗生素处方率(APR),多种抗生素处方率(MAPR),和广谱处方率(BAPR)。采用广义估计方程对抗生素使用相关因素进行分析。在155,262.2儿童加权处方中,APR,MAPR,BAPR为43.5%,9.9%,和84.8%。在国家一级,J01DC第二代头孢菌素是处方最多的抗生素类别(21.0%,N=15,313.0),其次是J01DD第三代头孢菌素(17.4%,N=12,695.8)。观察组抗生素占总抗生素处方的55.0%(N=52,056.3)。在诊断层面,呼吸道感染占抗生素处方的67.4%,其中诊断为潜在细菌性RTI的处方占最高的APR(55.0%)。对于每个诊断类别,MAPR和BAPR各不相同。年龄,区域,和诊断类别与抗生素使用相关.人们对抗生素使用的适当性提出了担忧,尤其是广谱抗生素。
There is scarce evidence to demonstrate the pattern of antibiotic use in children in China. We aimed to describe antibiotic prescribing practices among children in primary healthcare institutions (PHIs) in China. We described outpatient antibiotic prescriptions for children in PHIs from January 2017 to December 2019 at both the national and diagnostic levels, utilizing the antibiotic prescribing rate (APR), multi-antibiotic prescribing rate (MAPR), and broad-spectrum prescribing rate (BAPR). Generalized estimating equations were adopted to analyze the factors associated with antibiotic use. Among the total 155,262.2 weighted prescriptions for children, the APR, MAPR, and BAPR were 43.5%, 9.9%, and 84.8%. At the national level, J01DC second-generation cephalosporins were the most prescribed antibiotic category (21.0%, N = 15,313.0), followed by J01DD third-generation cephalosporins (17.4%, N = 12,695.8). Watch group antibiotics accounted for 55.0% of the total antibiotic prescriptions (N = 52,056.3). At the diagnostic level, respiratory tract infections accounted for 67.4% of antibiotic prescriptions, among which prescriptions with diagnoses classified as potentially bacterial RTIs occupied the highest APR (55.0%). For each diagnostic category, the MAPR and BAPR varied. Age, region, and diagnostic categories were associated with antibiotic use. Concerns were raised regarding the appropriateness of antibiotic use, especially for broad-spectrum antibiotics.