Abstract
China introduced a new policy regarding the management of antibiotic use. We evaluated the reasonableness of antibiotic use among children suffering from intussusception before and after policy. A retrospective study was conducted involving 234 young children with intussusception who were treated between January 1, 2011 and December 30, 2013. Demographics and detailed antibiotics regimens were collected. χ 2 test was used to evaluate differences between the phase I (preintervention, n = 68) and phase II (postintervention, n = 166). We determined that the overall antibiotic use rate following successful air enema reduction was 41% (97/234), which decreased from 99% (67/68) in phase I to 18% (30/166) in phase II. In phase I, prophylactic antibiotic usage reached up to 84% (56/67). The quantity of aztreonam for injection accounted for 63% (45/71), and cefamandole nafate for injection accounted for 25% (18/71). In phases II, prophylactic antibiotic usage were reduced to 13% (4/30). The quantity of aztreonam for injection was decreased to 12% (4/33) and cefamandole nafate for injection was 3% (1/33). Antibiotics' options were more diverse. In conclusion, policy intervention was effective in addressing some aspects of antibacterial drug usage among young children with intussusception. However, excessive drug use remains a public health problem. The guidelines for the antibiotic management of intussusception for children must be established in China.
Highlights
Intussusception occurs worldwide; its incidence is approximately 1 to 4 out of every 2000 infants, and with a peak prevalence within their first 3 years of life [1]
In 2011, the World Health Organization (WHO) published a warning regarding the risk of injudicious antibiotic use [6]
In phase II, the proportion of antibiotic use decreased to 18% (30/166). 87% of antibiotics were used for treatment (26/30), and only 13% for prevention (4/30)
Summary
Intussusception occurs worldwide; its incidence is approximately 1 to 4 out of every 2000 infants, and with a peak prevalence within their first 3 years of life [1]. It is a pediatric emergency and the second most common cause of gastrointestinal obstruction among young. The majority of hospitals administered antibiotics to children following successful air enema reductions. The Ministry of Health in China conducted a remediation regarding the clinical use of antibiotics to curb their overuse, primarily at large hospitals [7]. We evaluated the use of antibiotics in young children with intussusception after successful air enema reduction
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