Clinical investigation and antibiotic treatment in 394 cases of school-agechildren with influenza-like illness

doi:10.3877/cma.j.issn.1674-1358.2016.02.023

Abstract

Abstract:

Objective

To investigate the clinical characteristic and antibiotic treatment in 394 cases of school-agechildren with influenza-like illness (ILI) in the winter of 2014, and to provide the reference for clinical diagnosis and treatment.

Methods

Total of 394 school-agechildren with influenza-like illness who need the proof of full recovery for class in our infection clinic were analyzed using case-control study, retrospectively. All the cases were divided into two groups according to whether or not using antibiotics. The general conditions, clinical character, laboratory tests, whether or not visited hospital, the grade of hospital, treatment and prognosis were compared, respectively. Statistical analysis were taken by SPSS 13.0 software, the comparison of quantitative data was done using independent t test or rank test, and the qualitative data was compared using Chi-square test.

Results

The gender, age, the highest body temperature, cough, sore throat, headache, catarrhal symptoms, fever time and days from onset to recovery in the 394 school-agechildren with ILI between the two groups were not significantly different. The total white blood cell and neutrophils count were significantly lower in patients with non-antibiotic treatment compared with patients with antibiotic treatment. The utilization rates of antibiotics were investigated in first-grade hospital, third-grade hospital, and non-attendance in hospital as follows: 84.2% (149/177), 69.6% (110/158) and 63.6% (35/55). The differences between first-grade hospital and third-grade hospital were significant, but third-grade hospital and non-attendance in hospital were with significant differences. Twenty-five (6.3%) cases were detected with influenza A viruses by GICA or RT-PCR, only 5 (1.3%) cases with influenza A antigen positive using the rapid detection of GICA were given oseltamivir for antiviral therapy.

Conclusions

The utilization rate of antibiotics was high in school-agechildren with influenza-like illness. Whether or not using antibiotics has no effect on clinical manifestation and prognoses. The work of monitoring influenza virus pathogen for the patients with ILI in the flu season should be actively carried out, so as to provide good technical support for clinical diagnosis and treatment. At the same time. The clinic should be strengthened to master the reasonable evidence for the use of antibiotics and antiviral treatment.

Key words: Influenza-like illness, School-agechildren, Antibiotic antiviral etiology

Xiaojie Wang, Jiye Cui, Xing Zhou. Clinical investigation and antibiotic treatment in 394 cases of school-agechildren with influenza-like illness[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 240-243.

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References 18

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组别	例数	男/女（例）	年龄（±s，岁）	最高体温（±s，℃）	临床症状[例（%）]
组别	例数	男/女（例）	年龄（±s，岁）	最高体温（±s，℃）	咳嗽	咽痛	头痛	卡他症状
未用抗菌药物者	96	52/44	9.4 ± 1.5	38.8 ± 0.6	61（63.5）	23（24.0）	32（33.3）	41（42.7）
使用抗菌药物者	298	153/145	9.3 ± 1.5	38.8 ± 0.6	234（78.5）	105（35.2）	89（29.9）	133（44.6）
统计量		χ² = 1.470	Z = 0.375	Z =-0.503	χ² = 2.895	χ² = 1.937	χ² = 0.674	χ² = 0.005
P值		0.701	0.702	0.502	0.089	0.164	0.412	0.946

组别	例数	男/女（例）	年龄（±s，岁）	最高体温（±s，℃）	临床症状[例（%）]
组别	例数	男/女（例）	年龄（±s，岁）	最高体温（±s，℃）	咳嗽	咽痛	头痛	卡他症状
未用抗菌药物者	96	52/44	9.4 ± 1.5	38.8 ± 0.6	61（63.5）	23（24.0）	32（33.3）	41（42.7）
使用抗菌药物者	298	153/145	9.3 ± 1.5	38.8 ± 0.6	234（78.5）	105（35.2）	89（29.9）	133（44.6）
统计量		χ² = 1.470	Z = 0.375	Z =-0.503	χ² = 2.895	χ² = 1.937	χ² = 0.674	χ² = 0.005
P值		0.701	0.702	0.502	0.089	0.164	0.412	0.946

组别	例数	WBC（× 10⁹/L）	中性粒细胞计数（× 10⁹/L）	淋巴细胞计数（× 10⁹/L）	CRP（mg/L）	发热持续时间（d）	病程持续时间（d）
未用抗菌药物组	96	7.01 ± 1.90	4.42 ± 1.72	1.92 ± 0.87	6.07 ± 3.92	2.14 ± 0.80	3.90 ± 1.41
使用抗菌药物组	298	8.88 ± 3.24	6.29 ± 2.96	1.79 ± 0.79	12.16 ± 15.30	2.09 ± 0.85	4.44 ± 1.70
统计量		t =-3.905	Z =-4.320	t = 0.178	Z =-3.495	Z = 0.464	Z=-2.270
P值		< 0.001	0.006	0.443	0.139	0.611	0.060

组别	例数	WBC（× 10⁹/L）	中性粒细胞计数（× 10⁹/L）	淋巴细胞计数（× 10⁹/L）	CRP（mg/L）	发热持续时间（d）	病程持续时间（d）
未用抗菌药物组	96	7.01 ± 1.90	4.42 ± 1.72	1.92 ± 0.87	6.07 ± 3.92	2.14 ± 0.80	3.90 ± 1.41
使用抗菌药物组	298	8.88 ± 3.24	6.29 ± 2.96	1.79 ± 0.79	12.16 ± 15.30	2.09 ± 0.85	4.44 ± 1.70
统计量		t =-3.905	Z =-4.320	t = 0.178	Z =-3.495	Z = 0.464	Z=-2.270
P值		< 0.001	0.006	0.443	0.139	0.611	0.060

就诊情况	例数	抗菌药物使用[例（%）]		t值			P值
就诊情况	例数	是	否	一级医院	三级医院	未诊
一级医院	177	149（84.2）	28（15.8）		3.216		0.001
三级医院	158	110（69.6）	48（30.4）			0.817	0.207
未诊	55	35（63.6）	20（36.4）	3.350			0.001
合计	390	294	96

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