scholarly journals The Construction of Patient Understandings of Antibiotic use for Upper Respiratorytract Infections in Rural China.

Author(s):  
Jing Cheng ◽  
Paul I. Kadetz ◽  
Jing Chai ◽  
Xingrong Shen ◽  
Christie Cabral ◽  
...  

Abstract Background: This paper seeks to identify the lay understandings concerning “anti-inflammatories”, their relation to antibiotics, and their utilization in treating upper respiratory tract infections (RTIs) among patients in rural Anhui Province, China. Methods: In-depth semi-structured interviews were carried out with 30 patients from rural clinics who presented with RTI symptoms between December 2017 and May 2018. These patient-informants were purposively sampled for follow-up interviews from an original sample of 1,030 patients who completed preliminary structured interviews. All informants were over 18 years old and had consulted a doctor at village- or township-level government health facilities for symptoms of RTIs within two weeks preceding follow-up interviews. Data was collected until saturation was achieved. Responses were audiotaped, transcribed, and analyzed using a thematic framework via NVivo 12.0 software. Results: A majority of informants reported that antibiotics such as cephalosporin, known colloquially as “anti-inflammation medicine”, are the preferred treatment for upper respiratory tract symptoms. These are commonly prescribed by township and village doctors, who are an important source of antibiotic-related information for patients. Approximately 87% (n=26) of patient informants reported that doctors neither revealed the name nor classification of their diagnosis. Only 13% (n=4) were specifically told they had an upper respiratory tract infection. However, all patients in this sample were treated with antibiotics regardless of diagnosis or pathogenic etiology. Conclusion: The findings of the present study may provide important insights for designing future interventions to promote public health awareness concerning unnecessary and inappropriate use of antibiotics in China.

Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.


2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.


2020 ◽  
Vol 11 (3) ◽  
pp. 201-211
Author(s):  
İ.E. Emre ◽  
Y. Eroğlu ◽  
A. Kara ◽  
E.C. Dinleyici ◽  
M. Özen

Prevention of acute upper respiratory tract infections (URTIs) is becoming an increasingly important concept in public health application due to the increase in antibiotic resistance. Probiotics have been shown to have some effect on prevention in various reviews. In this study we aimed to re-asses the effect of probiotics as there has been a substantial increase in literature regarding the effects and safety of probiotics in the paediatric population. Two major databases were systematically searched to identify clinical trials eligible for inclusion. Study selection, data extraction and quality assessment were carried out by two reviewers. This review comprises 33 randomised controlled trials (RCTs) applied to a paediatric population with high-quality methodology. The primary outcome for this review was the incidence of respiratory tract infections. Secondary outcomes were severity of symptoms, missed days of school, incidence of antibiotic use and safety of prebiotic use. This review showed that probiotics have an impact on decreasing the incidence of URTIs and the severity of symptoms. The use of probiotics is extremely safe and as studies increase in evaluation of the effect of probiotics more and more show a significant beneficiary effect. Although still a long way from becoming a unanimous treatment modality, the small positive changes that probiotics have on URTIs is important to consider and the use of probiotics should be encouraged more.


2001 ◽  
Vol 37 (6) ◽  
pp. 0698-0702 ◽  
Author(s):  
Ralph Gonzales ◽  
John G. Bartlett ◽  
Richard E. Besser ◽  
John M. Hickner ◽  
Jerome R. Hoffman ◽  
...  

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