Multicenter investigation of treatment for acute phase infant wheezing in outpatient departments in Shanghai areas / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the treatment of infant wheezing during acute phase in the pediatric out-patient departments of two tertiary hospitals and two secondary hospitals in Shanghai.Methods Simple random sam-pling method was adopted.Standardized questionnaires were given to the parents and physicians of infants who suffered wheezing during the acute phase to survey the treatment methods in the pediatric outpatient departments of two tertiary hospitals(Xinhua Hospital,Shanghai Children's Medical Center)and two secondary hospitals(Putuo District People's Hospital,Renhe Hospital)from February to May 2015 in Shanghai area.All data were analyzed by using SPSS 20.0 software.The enumeration data were used to describe the frequency distribution,composition ratio,and the rates among different groups were compared by the χ2test.Results The survey questionnaires were withdraw from 264 cases,of which 166 were boys and 98 were girls.In the treatment of acute exacerbation,the rate of antibiotic use was 94.7%(250/264 cases),in which 67.0%(177/264 cases)were intravenous drugs;62.1%(164/264 cases)patients were using inhaled glucocorticoid and short-acting beta-agonists as the main drugs for treatment;the ratio of systemic glu-cocorticoid using was 52.3%(138/264 cases),and the ratio of intravenous method was 43.2%(114/264 cases) among the cases.The usage ratio of systemic beta-agonist,anti-leukotrienes and antihistamines were 83.0%(219/264 cases),30.3%(80/264 cases)and 41.3%(109/264 cases),respectively.Of the 206 cases with respiratory in-fection,the rate of antibiotics use reached 98.5%(203/206 cases),and among the 58 cases without respiratory infec-tion,and the rate of antibiotics use acounted to 84.5%(49/58 cases).The difference between the two groups was sta-tistically significant(χ2=20.6,P<0.01). There were 200 cases of children with atopic physique background,of whom,42.5%(85/200 cases)were treated with antihistamine and 34%(68/200 cases)were treated with anti-leu-kotriene drugs.There were 64 cases without atopic physique background,of whom,37.5%(24/64 cases)were treated with antihistamine and 18.8%(12/64 cases)were treated with anti-leukotriene drugs.The proportion of anti-leuko-triene drug use in children with atopic physique background was significantly higher than that in children without atopic physique background,and the difference between two groups was statistically significant(χ2=5.34,P<0.05).Except for antihistamine treatment,the distribution of other treatments in different hospitals or outpatient departments was simi-lar(all P>0.05).Conclusions Nebulized glucocorticoid and beta-agonist therapy has become the routine treatment for infant wheezing in the acute phase in the tertiary and secondary level hospitals in Shanghai.The treatment of infant wheezing needs to be further standardized since the use of antibiotics,systemic glucocorticoids and intravenous drugs is excessive.