背景:水痘是一种高度传染性疾病,特别是影响儿童,这可能导致需要抗生素或住院治疗的并发症。用于水痘管理的抗生素使用记录很少。这项研究评估了英格兰儿科人群中水痘的抗生素使用及其并发症。
方法:数据来自临床实践研究数据链和医院事件统计数据集的医疗记录。该研究包括2014-2018年期间诊断为水痘的年龄<18岁的患者,并进行了3个月的随访。我们确定了水痘相关的并发症,药物使用,医疗保健资源利用,以及从诊断到诊断后3个月的费用。
结果:我们确定了114578例原发性水痘患儿。其中,7.7%(n=8814)有水痘相关并发症,最常见的是耳朵,鼻子,和咽喉相关(37.1%[n=3271])。总之,25.9%(n=114578中的29706)开了抗生素。有并发症的患者比没有并发症的患者使用抗生素的比例更高(64.3%[8814中的n=5668]vs22.7%[105764中的n=24038])。研究队列的平均年度水痘相关费用为2231481英镑。总的来说,抗生素处方费用约为262007英镑。
结论:这项研究强调了与水痘管理相关的高抗生素使用和医疗保健资源利用。特别是有并发症的患者。英国的国家水痘疫苗接种计划可能会减少水痘负担和相关并发症,药物使用,和成本。
BACKGROUND: Varicella is a highly infectious disease, particularly affecting children, that can lead to complications requiring antibiotics or hospitalization. Antibiotic use for
varicella management is poorly documented. This study assessed antibiotic use for varicella and its complications in a pediatric population in England.
METHODS: Data were drawn from medical records in the Clinical Practice Research Datalink and Hospital Episode Statistics data sets. The study included patients <18 years old with varicella diagnosed during 2014-2018 and 3-month follow-up available. We determined varicella-related complications, medication use, healthcare resource utilization, and costs from diagnosis until 3 months after diagnosis.
RESULTS: We identified 114 578 children with a primary
varicella diagnosis. Of these, 7.7% (n = 8814) had a varicella-related complication, the most common being ear, nose, and throat related (37.1% [n = 3271]). In all, 25.9% (n = 29 706 of 114 578) were prescribed antibiotics. A higher proportion of patients with complications than without complications were prescribed antibiotics (64.3% [n = 5668 of 8814] vs 22.7% [n = 24 038 of 105 764]). Mean annualized
varicella-related costs were £2 231 481 for the study cohort. Overall, antibiotic prescriptions cost approximately £262 007.
CONCLUSIONS: This study highlights high antibiotic use and healthcare resource utilization associated with varicella management, particularly in patients with complications. A national
varicella vaccination program in England may reduce
varicella burden and related complications, medication use, and costs.