Children with respiratory tract infections were analyzed for antibiotic use. In more than 70.02% (1948/2782 cases), children took one or more types of antibiotics, with two types used in 16.64% (463 cases) and three or more types in 7.37% (205 cases). Among them, 1106 cases suffered from fever; 32 cases had lower than normal white blood cell counts, with 24 cases using antibiotics, accounting for 75%; within the normal range of white blood cell count, there were 554 cases, with 515 cases using antibiotics, accounting for 92.96%; higher than the normal white blood cell count were 520 cases, all using antibiotics. The most commonly used antibiotic was amoxicillin at 38.72% (1013/2616), followed by azithromycin at 22.97% (601 cases), cefaclor at 16.17% (423 cases), erythromycin at 11.20% (293 cases), roxithromycin at 9.79% (256 cases), clavulanic acid at 9.25% (242 cases), and sulfonamides at 4.34% (114 cases).
The choice of antibiotics was based on: (1) Past experience of drug users at 39.83% (1042/2616 cases), where family members of the child chose drugs based on their own illness and medication experiences at 19.23% (503 cases), while others chose based on past experiences of the child taking medications at 20.60% (539 cases); (2) Recommended by pharmacy clerks or others at 28.25% (739 cases); (3) Guidance from physicians accounted for 25.15% (658 cases); (4) Families reading science books about medication accounted for 6.77% (177 cases).
In the use of antibiotics for tract infections, some unreasonable phenomena exist: (1) Indiscriminate use: Antibiotics are often used for fevers and upper respiratory tract infections. Fever is just a symptom of disease manifestation, not necessarily indicative of a specific disease. The cause of the fever, especially in children with upper respiratory tract infections, is mostly due to viral infections, which cannot be simply treated with antibiotics. In this survey, 95.75 percent of children with fever used antibiotics, even when white blood cells were lower than normal or within the normal range. (2) Over-reliance on broad-spectrum antibiotics. Some doctors fail to recognize that anti-infective treatment is a gradual process. They start by using broad-spectrum antibiotics or switch to them after one day if they feel symptoms have not significantly improved, leading to increased bacterial resistance. (3) Improper methods of use, such as not taking medication on time or according to dosage instructions. Short or non-standard medication usage can lead to bacterial resistance, increasing the difficulty of treatment and posing health hazards.
The causes of irrational antibiotic use include: (1) Influence of advertising on family members of children, where antibiotics are seen as effective drugs for fever, leading to significant increases in antibiotic use within a given period; (2) Financial gain by some units selling drugs to make up for funding shortages, promoting irrational use of antibiotics; (3) Poor knowledge of antibiotics among families of children, who do not understand that fever can have various causes. After taking an antibiotic a few times, they claim poor efficacy, ignoring the nature of the disease itself and blindly changing antibiotics or increasing the variety; (4) A small number of medical staff use antibiotics as one of the means for self-protection against fever in patients, contributing to the abuse of antibiotics.
In conclusion, the rational use of antibiotics is a complex and urgent issue. It requires medical staff to strive to improve their expertise, follow clinical guidelines developed by experts, regulate the use of antibiotics, promote extensive medical science advocacy so that families of children understand common childhood diseases and antibiotics, and the government should strengthen management and strictly control the production, sales, and other links of antibiotics to prevent unreasonable application from various aspects.