The study of etiology of respiratory infection and antibiotics employment in pediatric patients

Abstract

Objective To research the pathogenies' types and analyze the antibacterial drug' s using rationality from the children with acute respiratory infection,our study were generated by pediatric department from the hospital lasting 2 years.Methods A total of 93 pediatric patients with acute respiratory infection admitted from December 1,2010 through November 30,2012 were enrolled into study.The throat swabs from 93 patients were sent to the Beijing Center for Disease and Prevention (CDC) to identify the influenza virus,syncytial virus and mycoplasma with rapid nucleic acid test.The specimens of sputum from hospitalized patients were sent to the hospital bacterial laboratory for bacteria culture.With the Children Drug Utilization Index (cDUI),the rationality of using antibiotics was estimated.The database was established by using SPSS version 18.0 software and the data were analyzed to determine the statistical distinction among the percentage by the Chi square test (P ＜ 0.05).Results Of them,70.96％ pediatric patients were below 3 years old (excluding newborns).Of them,62.36％ patients had positive findings of viral infection.The predominant viruses of respiratory infection were syncytial virus accounting for 30.43％,the influenza viruses 24.63％ and the para-influenza virus 10.14％.The patients with positive results in vital test were more vulnerable to lower respiratory infection than those with negative results.The pneumonia patients with positive finding of syncytial virus accounted for 85.71％ (18 patients) in which the median cDUI was 1.30.The antibiotics were given to 28 pneumonia patients with positive virus test,in which the median cDUI was 1.05.Of 28 pneumonia patients,4 (16％) had positive bacteria growth in sputum cultures,and 4 cases (16％) had positive bacteria growth in blood cultures.Conclusions In the district of hospital,the lower respiratory infection was usually caused by viruses.Therefore,antibiotics should not be given in patients without evidence of bacterial infection.It is a irrational strategy to use antibiotics in those patients when the Children Drug Utilization Index is high (＞ 1.0).It is paramount important to notice that the percentage of positive bacteria growth in sputum cultures is usually not high because the antibiotics are given by OPD physicians before hospitalization of patients with bacterial infections in the acute respiratory illness. Key words: Pneumonia; Children ; Infection ; Drug utilization index; Antimicrobial agents