儿童急性腹泻的处方模式:对印度马哈拉施特拉邦儿科医生的调查

Vikram Patra, J. Gavhane, Priyanka S. Amonkar
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引用次数: 0

摘要

背景:儿童急性腹泻药物的不合理使用十分猖獗。我们进行这项调查是为了分析儿科医生对急性腹泻的处方做法及其与标准治疗指南的偏差。研究对象和方法:在2021年世界口服补液盐(ORS)周期间,通过WhatsApp上的各种学术小组,在印度马哈拉施特拉邦的儿科医生中分发了一份关于处方实践的自我管理的在线问卷。问卷是匿名的,由15个强制性封闭式选择题组成。结果:282名儿科医生参与。其中,88.9%的参与者表示在急性腹泻时使用口服补液,26.8%的参与者只在水样腹泻时使用补锌,62%的参与者使用益生菌或益生菌加锌组合,60%的参与者使用消旋卡多曲等抗分泌药物。40%的参与者承认他们偶尔使用抗生素来治疗急性腹泻,而5%的人说他们经常这样做。大多数儿科医生建议适当的补液盐替代品。大量儿科医生认为益生菌(51.2%)、饮食限制(15.7%)、消旋卡多曲(10.5%)和抗生素(6.3%)是治疗急性腹泻的重要组成部分。只有25.4%的儿科医生回答正确,并表示家长咨询与锌和ORS治疗效果最好。结论:本研究表明儿科医生对急性腹泻管理标准治疗指南的依从性较低。滥用抗生素和不科学用药是本研究的证据。儿科医生对ORS优势的认识很高。目前,有必要关注适当的饲养方法,强调锌的作用,劝阻使用抗生素、益生菌、抗分泌药物和不合理的组合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prescribing pattern for acute diarrhea in children: A survey of pediatricians from Maharashtra, India
Context: Irrational use of medications for acute diarrhea in children is rampant. We conducted this survey to analyze prescription practices among pediatricians for acute diarrhea and their deviation from standard treatment guidelines. Subjects and Methods: A self-administered online questionnaire regarding prescription practices was circulated among pediatricians in Maharashtra, India, through various academic groups on WhatsApp, during the World Oral Rehydration Salt (ORS) Week, 2021. The questionnaire was anonymous and consisted of 15 compulsory close-ended multiple-choice questions. Results: Two hundred and eighty-seven pediatricians participated. Among which, 88.9% of the participants said that they prescribed ORS in acute diarrhea, 26.8% preferred zinc supplementation only in the case of watery diarrhea, 62% used probiotics or probiotics plus zinc combinations, and 60% said that they prescribe antisecretory drugs such as racecadotril. Forty percentage of the participants admitted that they occasionally use antibiotics for the management of acute diarrhea, while 5% said that they frequently do so. Most pediatricians advise appropriate ORS substitutes. Large number of pediatricians perceived probiotics (51.2%), dietary restriction (15.7%), racecadotril (10.5%), and antibiotics (6.3%) to be an important part in managing acute diarrhea. Only 25.4% of the pediatricians answered correctly and said parental counseling along with zinc and ORS work best as treatment. Conclusions: This study demonstrates low adherence by pediatricians to standard treatment guidelines for the management of acute diarrhea. Misuse of antibiotics and unscientific use of drugs were evidenced from this study. Awareness regarding the advantages of ORS among pediatricians is high. At present, there is a need to focus on appropriate feeding practices, emphasizing on the role of zinc and discouraging use of antibiotics, probiotics, antisecretory drugs, and irrational combinations.
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