抗生素与止咳药治疗儿童尿路感染相关急性咳嗽疗效的前瞻性研究。

IF 2.3 Multidisciplinary Respiratory Medicine Pub Date : 2016-06-13 eCollection Date: 2016-01-01 DOI:10.1186/s40248-016-0059-y
Alessandro Zanasi, Luigi Lanata, Federico Saibene, Giovanni Fontana, Peter V Dicpinigaitis, Valentina Venier, Francesco De Blasio
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引用次数: 14

摘要

背景:急性咳嗽通常是病毒性上呼吸道感染(URTI)后最常见的症状之一,促使人们去看卫生保健提供者。最近在医学文献中强调,在患有尿路感染的儿童中过度使用抗生素可能导致相关的副作用,而没有任何有益的效果。尽管早期不适当的抗生素处方可以提高父母的满意度,但尿路感染主要是病毒感染,通常是自限性的。因此,本研究的目的是分析抗生素与对症药物(中枢和外周止咳药)相比,在儿科人群中治疗尿路感染相关咳嗽的有效性。方法:这是一项前瞻性观察研究,330名儿童因急性咳嗽就诊。在基线和治疗6天后(抗咳药123例,抗生素89例或联合使用38例)或未治疗(80例)评估咳嗽的严重程度、频率和类型。分析6天后咳嗽处理的结果,包括症状缓解、改善、无变化或恶化。研究评估是通过对家长进行标准化问卷调查进行的。结果:两组患儿咳嗽缓解程度差异有统计学意义。此外,如果考虑外周性止咳药,咳嗽的缓解率明显高于抗生素(p结论:抗生素在治疗普通感冒引起的急性咳嗽中一般无效,也不合适。此外,不适当的抗生素使用会带来不良副作用的可能性,并促进抗生素耐药性。本研究的结果表明,抗咳药,特别是外周作用的药物,是治疗小儿泌尿道感染引起的急性咳嗽的有效选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Prospective study of the efficacy of antibiotics versus antitussive drugs for the management of URTI-related acute cough in children.

Background: Acute cough is one of the most frequent symptoms prompting a visit to a health care provider, usually following a viral upper respiratory tract infection (URTI). The disproportionate use of antibiotics in children with URTIs, recently highlighted in the medical literature, could lead to associated side effects, without any beneficial effect. Although an early, albeit inappropriate, antibiotic prescription increases parental satisfaction, URTIs are predominantly viral infections and are generally self-limiting. Therefore the aim of this study was to analyze the effectiveness of antibiotics compared to symptomatic drugs (central and peripheral antitussives) on URTI-related cough in a pediatric population.

Methods: This is a prospective observational study of 330 children who required pediatric consultation for acute cough. Severity, frequency and type of cough were assessed at baseline and after 6 days of treatment (antitussives n = 123, antibiotics n = 89 or combination of them n = 38) or no treatment (n = 80). The outcome of cough management after 6 days was analyzed in terms of resolution, improvement, no change or worsening of symptoms. Study assessments were performed using a standardized questionnaire administered to parents.

Results: Between children treated with antitussives or antibiotics, there was a statistically significant difference in the resolution of cough. Moreover, if considering peripheral antitussives, the resolution of cough was significantly higher with antitussives than with antibiotics (p < 0.01). There was no difference in cough resolution between children treated with antitussives and those receiving a combination of antibiotics and antitussives, either central and peripheral antitussives.

Conclusion: Antibiotics are generally not useful nor appropriate in treating acute cough due to the common cold. Furthermore, inappropriate antibiotic use introduces the possibility of adverse side effects as well as promotion of antibiotic resistance. The findings of the present study suggest that antitussives, especially peripherally acting agents, represent an effective treatment option for acute pediatric cough caused by URTIs.

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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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