PROFILE AND APPROPRIATE USE OF ANTIBIOTICS AMONG CHILDREN IN A GENERAL HOSPITAL IN SOUTHERN BRAZIL

ABSTRACT Objective: To examine the profile and appropriate use of antibiotics among hospitalized children. Methods: A cross-sectional study was conducted with children who had taken antibiotics during hospitalization in a private philanthropic hospital in Southern Brazil, from January to December 2015. The data were obtained by reviewing medical records, encompassing demographic data (age, gender, ethnicity, and body weight) and clinical data (causes of hospitalization, use of antibiotics, and clinical outcome). Descriptive statistics was used to present the data. Results: Of the 318 participants included in the study, 61.3% were male patients. The age range varied between 2 and 11 years, with mean age of 5.8±2.9 years. The prevalence of antibiotics was 24.4% out of the 1,346 hospitalized children. Median hospital stay was four days. The main cause of hospitalization was clinical instability, and the most commonly prescribed antibiotics was Cefazolin, mostly administered intravenously. Regarding the administration of antibiotics, 62.2% were adequately prescribed, even though underdose was 11.7%, and overdose was 14.6% in the studied patients. Antibiotic administration intervals were characterized as long in 8% of cases, and short in 3.5% of cases. Conclusions: Although the prevalence of antibiotics among hospitalized children was not that high, a considerable part of the sample presented inadequacy regarding the dosage and range of use. These data raise concerns about bacterial resistance and adverse reactions.

摘要
研究目的：探讨住院儿童的抗生素使用现状及合理用药情况。
方法：本研究于2015年1月至12月期间，在巴西南部一家私立慈善医院开展横断面研究，纳入住院期间使用过抗生素的儿童作为研究对象。通过查阅病历收集研究数据，涵盖人口统计学资料（年龄、性别、种族与体重）及临床资料（住院原因、抗生素使用情况与临床转归），采用描述性统计学方法对数据进行分析展示。
结果：本研究共纳入318名研究对象，其中男性占比61.3%。研究对象年龄跨度为2~11岁，平均年龄为5.8±2.9岁。在1346名住院儿童中，抗生素使用率为24.4%。中位住院时长为4天。住院的主要诱因为临床病情不稳定，临床最常开具的抗生素为头孢唑林（Cefazolin），且多采用静脉给药方式。关于抗生素给药方案，62.2%的给药方案合理，但研究对象中给药剂量不足的占比为11.7%，给药剂量过量的占比为14.6%。另有8%的病例存在给药间隔过长的问题，3.5%的病例存在给药间隔过短的问题。
结论：尽管住院儿童的抗生素使用率并不高，但仍有相当比例的研究对象存在抗生素给药剂量与使用范围不合理的情况。本研究结果提示需警惕细菌耐药性与药物不良反应的发生风险。