Antibiotic prescription in pediatric patients with influenza in outpatient and emergency departments: A cross-sectional study

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-05 DOI:10.1016/j.jiph.2025.102730

Ya-Nan Li , Xiao-Lu Nie , Yu-Chuan Li , Tian-Ming Chen , Xin Xu , Bing-Lin Jian , Liang Zhu , Jie Wu , Cheng-Song Zhao , Gang Liu

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引用次数: 0

Abstract

Background

Influenza is a common viral respiratory infection, and inappropriate antibiotic use may lead to increased drug resistance and unnecessary waste of healthcare resources. However, real-world antibiotic prescribing in pediatric influenza patients remains largely unknown in China.

Methods

We performed a cross-sectional study of outpatient and emergency department prescriptions in a tertiary children's hospital for pediatric patients diagnosed with influenza between January 1, 2021, and July 31, 2023. The study outcome was mainly the rate and classes of antibiotic prescription in pediatric influenza patients, grouped by age group, C-reactive protein concentration, before and after the lifting of the non-pharmacological interventions, and location of the visit. Other outcomes, including risk factors for prescribing antibiotics, were analyzed by binary logistic regression.

Results

The analysis included 39,110 pediatric patients with influenza between 2021 and 2023, and the antibiotic prescription rate was 13.0 % (5067/39,110). After excluding influenza cases with concurrent bacterial infection diagnosis, the antibiotic prescription rate decreased to 11.7 % (4460/38,200). Of these, 93.2 % (4157/4460) received both antiviral and antibiotics. Macrolide antibiotics were the most frequently prescribed (49.2 %), followed by cephalosporins (35.2 %). We found that factors significantly associated with antibiotic prescriptions included male sex, ages ≥ 2 years, OPD visit, the period of low influenza virus activity, underlying diseases, co-infections, clinical diagnosis, and high C-reactive protein levels.

Conclusions

Our findings highlight baseline antibiotic prescribing in children with influenza and predictors of prescribing behaviors to enhance further antibiotic stewardship programs.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.