Antimicrobial prescribing for outpatients with laboratory-confirmed influenza in a large children′s hospital: a retrospective study / 中国药学杂志

ABSTRACT

OBJECTIVE: To investigate the usage of antimicrobial in outpatients with laboratory-confirmed influenza in a children′s hospital during the flu season, and to provide evidence for scientific antimicrobial stewardship. METHODS: During the 2017-2018 flu season, medical records of laboratory-confirmed influenza positive cases in our hospital were reviewed to collect information including prescription of antimicrobial, laboratory data; and the rationality of the use of antimicrobial was evaluated based on clinical diagnosis. Logistic regression was used to establish the prediction model of antimicrobial usage, which was used to test the factors affecting usage of antimicrobial in outpatients with influenza infections. RESULTS: Among 201 confirmed-influenza cases, 107 (53.2%) were prescribed antimicrobial (at least one drug), and 92 (86.0%) were treated irrationally. In most patients, macrolides and the third generation of cephalosporins were used; and the most frequently used antimicrobials were azithromycin, cefixime and clarithromycin. According to the prediction model, the use of antimicrobial was significantly associated with abnormal C-reactive protein (CRP) level in children (adjusted OR=4.697; 95%CI 2.187-10.090) and negative results of rapid influenza diagnostic test (RIDT) (adjusted OR=2.228; 95%CI1.058-4.692); age, onset season, use of anti-influenza virus drugs, white blood cell counting, proportion of neutrophils, RIDT positive results, a clinical diagnosis of influenza and influenza typing were not risk factors. CONCLUSION: The rate of antimicrobial usage in out patients with in fluenza is high, and the management department should take targeted measures to reduce the unreasonable use of antimicrobial.