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India is the largest consumer of antibiotics in the world. High antibiotic consumption is linked to the emergence and community spread of multidrug-resistant bacteria. It is well-established that antibiotic overuse is one of the leading causes of antibiotic resistance, which is a major global public health challenge. Optimizing antibiotic usage is, thus, an essential issue. Before promoting and defining judicious antibiotic prescribing, it is crucial to analyze practitioners' diagnostic and prescribing practices. Hence, a nationwide retrospective questionnaire-based survey was conducted among 950 Indian doctors. This survey aimed to describe the approaches and practices of Indian doctors towards antibiotic use in upper respiratory tract infections (URTIs) and pyrexia of unknown origin (PUO) and compare practices with national guidelines. These are the most common reasons for primary health care consultations and significantly contribute to the overuse of antibiotics. According to the survey, amoxicillin-clavulanic acid remains the first-line antibiotic for URTI treatment. Third-generation cephalosporins were found to be the most prescribed antibiotics for PUO, uncomplicated typhoid and infections during pregnancy. Our survey results show that most of the clinicians in our study were well aware of the guidelines for antimicrobial use issued by Indian Council of Medical Research (ICMR) and the nationwide problem of antimicrobial resistance. This study provides an important insight into the prescribing practices of antibiotics among Indian doctors.
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Objective:To explore the clinical diagnosis and treatment characteristics as well as the optimal schemes of Lianhua Qingwen Capsule in the treatment of upper respiratory tract infection （URTI） in the real world. Method:The information of 454 patients receiving Lianhua Qingwen Capsule for URTI was collected from the electronic medical data warehouse constructed by the Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences， which covered 16 large-scale tertiary Class A hospital information systems （HISs）. The harvested information was subjected to descriptive analysis， Apriori algorithm-based analysis and Louvain （BGLL） algorithm-based complex network analysis to explore the clinical medication schemes. Result:The commonly adopted medication schemes were heat-clearing and detoxicating Chinese medicinal injections combined with expectorants， analgesic-antipyretic drugs， or antibacterial agents in western medicine. Besides， the combination with heat-clearing and phlegm-resolving Chinese medicinals， vitamins， or hypotensive， lipid-lowering， hypoglycemic， coronary circulation-improving， or antiplatelet aggregation drugs targeting the underlying diseases was also detectable. Conclusion:The complex network analysis based on BGLL clustering method can be used to find out the medication rules of Lianhua Qingwen Capsule for URTI. The traditional Chinese medicine has been widely employed for resolving phlegm and relieving cough due to its good efficacy. The combination with antibiotics follows the guidelines for the use of antimicrobial agents. Drug safety is one of the most concerned aspects in clinical drug combination. The uncovering of these rules has provided a direction for exploring the optimal treatments.
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A lot of experiments have been carried out in Saudi Arabia concerning the misuse of antibiotics and buying themwithout being prescribed by a doctor. However, despite all these studies, a few or none of them have appraisedthe parental awareness, practices and attitude toward the use of antibiotics in the treatment of URTIs in theirchildren. As such, the objective of this experiment was to document and analyze the parental levels of knowledge,attitudes, and practices (KAP) regarding the use for upper respiratory tract infections in children. This is a crosssectional study that was conducted across 8 cities: Riyadh, Jeddah, Taif, Makkah, Dammam, Al Ahsa, Albahaand Asir Saudi Arabia from 01/09/2019 to 26/09/2019, according to which a total of 714 parents took part in thestudy. Convenience sampling was the method that was used to select the participants of the experiment. Thefindings of the current research were found to be the same as those of the studies that were conducted before inPalestine. The researcher found out that the parents in Saudi Arabia lack adequate knowledge regarding the useof antibiotics in the treatment of URTIs and this led to their wrong practices and attitudes toward the same.Despite all these, the study established a relationship of trust between the subjects and the doctors, meaning thatthere is a trust in the information and recommendations that the doctors give them concerning the medications.
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ABSTRACT INTRODUCTION: Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. OBJECTIVE: To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. METHODS: A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. RESULTS: Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p < 0.05); children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p < 0.05). Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p < 0.05); the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. CONCLUSIONS: Upper respiratory tract infections and otitis media are common childhood diseases strongly associated with low parental educational attainment (p = 0.0001), exposure to smoke (p = 0.0001), indoor exposure to mold (p = 0.0001), laryngopharyngeal reflux disease (p = 0.0002) and the lack of breast-feeding (p = 0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p = 0.0001). The modification of the identified risk factors for otitis media should be recommended to realize a correct primary care intervention.
RESUMO INTRODUÇÃO: A infecção de vias aéreas superiores é uma denominação inespecífica, empregada na descrição de uma infecção aguda envolvendo o nariz, os seios paranasais, a faringe e a laringe. As infecções de vias aéreas superiores em crianças estão frequentemente associadas à disfunção da trompa de Eustáquio, complicando-se com otite média, um processo inflamatório da orelha média. Já foram relatados vários fatores de risco relacionados à otite média, incluindo os ambientais, epidemiológicos e familiares (p. ex., gênero, fatores socioeconômicos e educacionais, exposição ao tabaco, alergia ou duração do aleitamento materno), entretanto, não dispomos de dados sobre sua ocorrência entre crianças sicilianas com infecções de vias aéreas superiores. OBJETIVO: Investigar os principais fatores de risco para otite média e sua prevalência em crianças sicilianas com e sem infecções de vias aéreas superiores. MÉTODO: Um estudo de caso-controle de 204 crianças com infecções de vias aéreas superiores apresentando otite média durante um período de monitoração de três semanas e 204 controles saudáveis compatíveis em idade e gênero. Foram relacionadas 17 características com relevância epidemiológica por meio da aplicação de questionários padronizados; também foram realizados testes cutâneos. Foram utilizadas análises univariada e de regressão logística multivariada no exame da associação entre fatores de risco e ocorrência de otite média. RESULTADOS: A otite média revelou forte associação com famílias numerosas, baixo nível educacional dos pais e escolaridade no terceiro ano de vida (p< 0,05); as crianças demonstraram maior suscetibilidade para ocorrência de otite média em presença de asma, tosse, doença do refluxo laringofaríngeo, ronco e apneia (p < 0,05). Alergia e localização urbana aumentaram o risco de otite média em crianças expostas ao fumo em 166% e 277% (p < 0,05), respectivamente; o efeito conjunto de asma e presença de animais de estimação na população alérgica aumentou o risco de recidiva em 11%, enquanto que, em conjunto, alergia, tosse e coriza aumentaram esse risco em 74%. CONCLUSÕES: As infecções de vias aéreas superiores e otite média são doenças pediátricas comuns, fortemente associadas a baixo nível educacional dos pais (p = 0,0001), exposição ao fumo (p = 0,0001), exposição domiciliar ao mofo (p = 0,0001), refluxo laringofaríngeo (p = 0,0002) e ausência de aleitamento materno (p = 0,0014). Também foi observado aumento do risco de recidivas de otite média em presença de alergia, tosse persistente e coriza (p = 0,0001). Deve-se recomendar a modificação dos fatores de risco identificados para otite média, para uma correta intervenção terapêutica primária.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Otitis Media/etiology , Respiratory Tract Infections/complications , Case-Control Studies , Italy/epidemiology , Otitis Media/epidemiology , Prevalence , Recurrence , Risk Factors , Respiratory Tract Infections/epidemiology , Socioeconomic FactorsABSTRACT
Strenuous exercise induces upper respiratory tract infection (URTI), whereas moderate exercise prevents URTI. This study aimed to assess the incidence of URTI and the association between URTI episodes and exercise duration in Japanese collegiate athletes. A cross-sectional survey was conducted with 1,740 participants; 1,235 responses were eligible for analysis. Participants were classified into three groups: control group (weekly total exercise duration <60 min, n=405), exercise group (weekly total exercise duration >60 min, n=193), and athlete group (joined a sports club and weekly exercise frequency >5 days, n=637). We requested the following information from participants: basic characteristics, incidence of URTI symptoms (fever, runny or plugged nose, sore throat, and cough) or influenza for each month over the past year, day of the week exercise is typically performed, and duration of exercise per week. The incidence of URTI episodes per year was significantly lower in the athlete group (2.0 ± 2.4 episodes) compared to the control group (2.6 ± 2.4 episodes, p<0.001). The incidence of URTI episodes did not significantly differ between the control group and exercise group (2.9 ± 2.9 episodes, p=0.607). Although the frequency of URTI episodes and exercise duration were not significantly associated among male athletes (p=0.209), they were positively associated in female athletes (p=0.027). These results indicate that Japanese collegiate athletes experience fewer URTI episodes than non-athletes, but athletes who exercise for long durations may frequently experience URTI, particularly female athletes.
ABSTRACT
Background: The most common infections among humans are the acute infections of the respiratory tract (ARTIs). The importance of ARIs in Saudi Arabia is relatively higher than anywhere else due to the annual Hajj pilgrimage season. There is a paucity of evidence in the literature about actual intervention strategies to improve respiratory infection control practices. Nevertheless, prevention has assumed a paramount importance in the fight against ARIs. Aims & Objective: To assess the knowledge of male secondary school students regarding prevention of ARIs and its determinants. Material and Methods: This is a cross-sectional study included male secondary school students studying at two randomly selected general governmental secondary schools in Abha City. Based on thorough literature review, the researcher has designed a self-administered Arabic questionnaire. It included the following: Personal characteristic of student as well as knowledge of students about prevention of ARIs including Measures to prevent respiratory infections, vaccination, importance of avoidance of sources of infection and early symptoms characterizing respiratory infections. Results: The study included 1030 male secondary school students. Their age ranged between 15 and 22 years with a mean of 17.12±1.06. Slightly less than half of the students (48.4%), recognized correctly the main causative agents for ARTIs while more than half of them (59.3%) recognized correctly the mode of transmission of ARTIs and the most susceptible victims for ARTIs (56.4%). Most of the students recognized correctly the different preventive measures of ARTIs (the percentage ranged between 84.9% for vaccination to 86.6% for proper hand washing several times daily). Students enrolled in the second or third grades, those whose mothers were university graduated, those having information from television or newspapers/magazines, those having a history of recent ARTI attach and being educated through physicians were less liable to have insufficient knowledge about ARTIs. Conclusion: Saudi male students` knowledge about respiratory tract infections and about antibiotic therapy is often lacking. Improved health education may alter students' expectations concerning antibiotic therapy for their illness.