Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Antibiotic | Research article

Prevalence and risk factors for antibiotic utilization in Chinese children

Authors: Shasha Guo, Qiang Sun, Xinyang Zhao, Liyan Shen, Xuemei Zhen

Published in: BMC Pediatrics | Issue 1/2021

Login to get access

Abstract

Background

Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China.

Methods

English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis.

Results

Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue.

Conclusion

The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.
Appendix
Available only for authorised users
Literature
1.
2.
3.
SSM N. Antibiotic resistance and the commensal flora: role of the commensal flora in the development and spread of antimicrobial resistance: Maastricht University Press; 2005.
4.
Van Boeckel TP, Gandra S, Ashok A, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14(8):742–50.PubMedCrossRef
5.
Heddini A, Cars O, Qiang S, et al. Antibiotic resistance in China--a major future challenge. Lancet. 2009;373(9657):30.PubMedCrossRef
6.
Zeman K. Effectiveness and tolerance of antibiotics in pediatrics patients. Pol Merkur Lekarski. 2011;30(179):352–4.PubMed
7.
Nicolini G, Sperotto F, Esposito S. Combating the rise of antibiotic resistance in children. Minerva Pediatrica. 2014;66(1):31–9.PubMed
8.
Pakyz AL, Gurgle HE, Ibrahim OM, et al. Trends in antibacterial use in hospitalized pediatric patients in United States academic health centers. Syst Rev. 2009;30(6):600–3.
9.
Hersh AL, Shapiro DJ, Pavia AT, et al. Antibiotic prescribing in ambulatory pediatrics in the United States. Pediatrics. 2011;128(6):1053–61.PubMedCrossRef
10.
Levy ER, Swami S, Dubois SG, et al. Rates and appropriateness of antimicrobial prescribing at an academic children’s hospital, 2007-2010. Infect Control Hosp Epidemiol. 2012;33(4):346–53.PubMedCrossRef
11.
Rutledge-Taylor K, Matlow A, Gravel D, et al. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control. 2012;40(6):491–6.PubMedCrossRef
12.
Versporten A, Bielicki J, Drapier N, et al. The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children. J Antimicrob Chemother. 2016;71(4):1106–17.PubMedCrossRef
13.
Yoshida S, Takeuchi M, Kawakami K. Prescription of antibiotics to pre-school children from 2005 to 2014 in Japan: a retrospective claims database study. J Public Health (Oxf). 2018;40(2):397–403.CrossRef
14.
Schindler C, Krappweis J, Morgenstern I, et al. Prescriptions of systemic antibiotics for children in Germany aged between 0 and 6 years. Pharmacoepidemiol Drug Saf. 2003;12(2):113–20.PubMedCrossRef
15.
Zhang W, Shen X, Wang Y, et al. Outpatient antibiotic use and assessment of antibiotic guidelines in Chinese children’s hospitals. Eur J Clin Pharmacol. 2008;64(8):821–8.PubMedCrossRef
16.
Nyquist AC, Gonzales R, Steiner JF, et al. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998;279(11):875–7.PubMedCrossRef
17.
Dong L, Yan H, Wang D. Antibiotic prescribing patterns in village health clinics across 10 provinces of Western China. J Antimicrob Chemother. 2008;62(2):410–5.PubMedCrossRef
18.
Rogawski ET, Platts-Mills JA, Seidman JC, et al. Use of antibiotics in children younger than two years in eight countries: a prospective cohort study. Bull World Health Organ. 2017;95(1):49–61.PubMedCrossRef
19.
Qu M, Lv B, Zhang X, et al. Prevalence and antibiotic resistance of bacterial pathogens isolated from childhood diarrhea in Beijing, China (2010-2014). Gut Pathogens. 2016;8:31.PubMedPubMedCentralCrossRef
20.
21.
China Antimicrobial Resistance Surveillance System: Surveillance of bacterial resistance in children and newborns across China from 2014 to 2017. Natl Med J China. 2018;98(40):3279–87.
22.
Chang H, Shen X, Fu Z, et al. Antibiotic resistance and molecular analysis of Streptococcus pyogenes isolated from healthy schoolchildren in China. Scand J Infect Dis. 2010;42(2):84–9.PubMedCrossRef
23.
Yin X, Song F, Gong Y, et al. A systematic review of antibiotic utilization in China. J Antimicrob Chemother. 2013;68(11):2445–52.PubMedCrossRef
24.
25.
Mao W, Wen C. The Zero Mark-up Policy for essential medicines at primary level facilities; 2015.
26.
27.
28.
29.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Plos Med. 2009;6(7):e1000097.PubMedPubMedCentralCrossRef
30.
Martin MF. Defining China's Rural Population. The China Quarterly. 1992;1992(130):392–401.
31.
Pacific WHOR. People’s Republic of China health system review: Manila : WHO Regional Office for the Western Pacific; 2015.
32.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef
33.
West S, King V, Carey TS, et al. Systems to rate the strength of scientific evidence No. 47. AHRQ Publication No. 02-E016. Rockville: Agency for Health care Research and Quality; 2002.
34.
Oremus M, Wolfson C, Perrault A, et al. Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer’s disease drug trials. Dement Geriatr Cogn Disord. 2001;12(3):232–6.PubMedCrossRef
35.
Liang X, Zhuo Y. Analysis of appliance of antibiotics about outpatient transfusion prescriptions in our hospital. Guangzhou Med J. 2010;41(4):65–6.
36.
Hu X. Analysis of the utilization of antibiotics in pediatric department of our hospital. China Pharm. 2010;21(44):4186–8.
37.
Chen C, Xin L, Tan F. Analysis on the use of antibacterials in pediatric outpatient department of our hospital. China Pract Med. 2010;5(29):9–10.
38.
Zhang J. Analysis on antibiotic treatment among pediatric outpatients in our hospital in 2010. Chin J Med Guide. 2011;13(12):2166 2172.
39.
Wang J, Li G, Xiang F. Analysis of antibiotic application in outptient pediatric prescriptions. Modern Hosp. 2011;11(5):57–8.
40.
Li X. The application situation analysis of antibiotic usage in outpatient department with acute upper respiratory infections in our hospital. China Modern Med. 2011;18(9):150–1.
41.
Liang J, Liang Y. Clinical observation of 500 cases with antibiotics in outpatient department of pediatrics. Contemp Med. 2012;30:144–5.
42.
Huang X, Xie J, Xu Y, et al. The investigation research of the prescription of antibiotic drugs in outpatient of the pediatric department of one hospital. Chin J Clin Ration Drug Use. 2012;5(36):1–2.
43.
Li H. Analysis and evaluation of drug application in pediatric outpatients of our hospital. China Med Herald. 2012;9(08):114–5.
44.
Chen L. Our hospital antimicrobial prescription pediatric clinic is not reasonable use analysis. J North Pharm. 2012;9(11):66–7.
45.
Zhou H, Lin Z, Lv D, et al. Investigation of the use of antibacterial drugs in pediatric outpatient department of our hospital. Chin J Pharmacovigilance. 2012;9(09):566–8.
46.
Li L, Feng L. Analysis of drugs application for upper respiratory tract infection in pediatric outpatient. China Med Herald. 2013;10(02):114–6.
47.
Xiao B. Analysis of the use of antibiotics in 1553 outpatient pediatric patients. Med J Natl Defending Forces Southwest China. 2013;23(07):779–80.
48.
Chen H, Zhu F, Lu H. Application analysis of antibacterial drugs in pediatric outpatient department of Lianzhou People’s Hospital. China Med Pharm. 2013;3(11):64–5.
49.
Liu H. The analysis of the pediatric outpatient anti-infective drug using. Hebei Med. 2013;19(03):436–9.
50.
Miao C, Lei H, Rong Y, et al. Medication analysis on pediatrics outpatient prescription at our hospital. China Health Ind. 2014;5(4):7.
51.
Zeng Y. Analysis on the pediatric prescriptions in the outpatient. Med Forum. 2014;1:121–3.
52.
Gui M, Wang J. To analyze the service condition of antibacterial agents of upper respiratory tract infection prescription in pediatric outpatient department. Chinese Community Doctors. 2014;5(15):7.
53.
Yuan Y, Cao L, Yu X, et al. Prescriptions of antibiotics for children with upper respiratory infections in outpatient department. Chin J Gen Pract. 2015;14(8):616–20.
54.
Xu P, Lin R. Investigation on current situation of using antibiotics for acute upper respiratory infection in Children. J Pediatr Pharm. 2015;21(7):47–9.
55.
Xu X, Liu T. Analysis of usage of anti-infection drugs in department of pediatrics in our hospital. China Med Pharm. 2015;5(24):72–4.
56.
Gao Y. Analysis of antibiotics in pediatric patients with acute upper respiratory tract infection. Chinese Community Doctors. 2016;32(19):13–4.
57.
Xie Y. MTP rationality of prescription and the effect of interventions in the treatment of acute upper respiratory tract infection in outpatient pediatrics. Anhui Med Pharm J. 2016;20(9):1784 -1786, 1787.
58.
Lin Y, Nie C, Yang L, et al. Analysis and evaluation of prescriptions for pediatric upper respiratory tract infection. China Licensed Pharmacist. 2016;13(2):15–8.
59.
Wang J. Evaluation of the use of antimicrobial drugs in pediatric outpatients with acute respiratory infection. J Trop Med. 2016;16(06):796–8.
60.
Wang S. Analysis of antibacterials usage in respiratory tract infection of outpatient department of pediatrics in our hospital. Chin J Drug Eval. 2017;34(4):290–3.
61.
Pan Y. Analysis on application of oral medicine for upper respiratory tract infections in our hospital. Chin Foreign Med Res. 2017;15(13):142–3.
62.
Nie C, Zhang J, Zhao Q, et al. Investigation and analysis of antibiotics application in pediatric clinic of our hospital. Modern Hosp. 2017;17(08):1223–5.
63.
Zhang Z, Hu Y, Zou G, et al. Antibiotic prescribing for upper respiratory infections among children in rural China: a cross-sectional study of outpatient prescriptions. Glob Health Action. 2017;10(1):1287334.PubMedPubMedCentralCrossRef
64.
Wei X, Zhang Z, Walley JD, et al. Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial. Lancet Glob Health. 2017;5(12):e1258–67.PubMedCrossRef
65.
Wei X, Yin J, Walley JD, et al. Impact of China’s essential medicines scheme and zero-mark-up policy on antibiotic prescriptions in county hospitals: a mixed methods study. Trop Med Int Health. 2017;22(9):1166–74.PubMedCrossRef
66.
Wang Z, Li L, Huang F, et al. Analysis of rational drug use of the pediatric prescriptions from 45 grassroots hospitals in an area. Pharm Adm. 2018;27(17):86–9.
67.
Wang C. Analysis of the use of antibiotics in outpatients with acute upper respiratory tract infections in pediatrics department. Clin Res Pract. 2019;4(03):118–9.
68.
Peng L, Wang Z, Zhang Y. Analysis of rational use of antibiotic drugs in hospital pediatrics based on children’s drug utilization index and drug safety. Boletin De Malariologia Y Salud Ambiental. 2019;59(1):89–95.
69.
Cui Y. Analysis of antibiotics in hospitalized children. Chin J Clin Ration Drug Use. 2011;04(23):43–4.
70.
Qiu Z, Xie L, Xie H. Application analysis on antibiotics in pediatric patient with acute upper respiratory tract infection. Chin J Clin Ration Drug Use. 2011;04(25):4–5.
71.
Chen J, Wen Z. Research study on antibiotic application for bronchopneumonia of the children in-patient in pediatrics in 2010. Int Med Health Guid News. 2011;17(24):3075–8.
72.
Lin Y. Analysis of antibiotics application in pediatric upper respiratory tract infection. Chin J Nosocomiol. 2011;21(12):2576–7.
73.
Liang Z, Li L, Li K. Analysis of the use of antibiotic in pediatric inpatients. Med Recapitulate. 2011;17(12):1890–1.
74.
Zhou L. The analysis of nosocomial infection and antibiotics usage in hospitalized neonates. China Pract Med. 2012;07(15):32–4.
75.
Bian H, Zhang T. Investigation of drug use in pediatrics in our hospital. Chin J Pharmacoepidemiol. 2012;21(3):138–9 145.
76.
Fang J. Antibiotics application in 196 pediatric patients with acute upper respiratory infection. J Modern Clin Med. 2012;38(2):123–4.
77.
Wu W. An empirical analysis of antibiotic drug usage in pediatrics. World Health Digest Med Periodieal. 2012;39:72–3.
78.
He M. Investigation of antibiotic use in hospitalized children with respiratory tract infection in our hospital from 2009 to 2011. Gems Health. 2012;4:389.
79.
Guan L. Investigation of antibiotic use in pediatric inpatient with acute upper respiratory tract infections. World Health Digest Med Periodieal. 2012;9(49):231–2.
80.
Jiang L, Yang P. Investigation and analysis of nosocomial infection and antibiotic application in 1148 hospitalized children. J Front Med. 2012;20:94–5.
81.
Zhu J, Shen N, Wang Y, et al. Application of antibiotics in neonatal wards. Chin J Nosocomiol. 2012;22(17):3836 -3837, 3840.
82.
Wang Q, Sun C, Xu Y. Analysis on the usage of antibacterials in pediatric inpatients. Chin J Drug Appl Monit. 2012;9(06):348–50.
83.
Che Y, Dong J. Use of antibiotics for neonates in a basic hospital and influencing factors analysis. Chin J Woman Child Health Res. 2013;24(3):296–8.
84.
Lu J, Huang J. Clinical analysis of antibiotics application for children with acute respiratory infection in Qinzhou. J Clin Pulmon Med. 2013;18(12):2210–2.
85.
Xu J. Analysis of the usage of antibacterials in pediatric inpatients. Chin J Pharmacoepidemiol. 2013;22(4):196–8.
86.
Huang X, Zhang W, Xu Q. Investigation of 215 medical records in internal medicine of pediatrics and analysis of antimicrobial drug Use. J Pediatr Pharm. 2013;19(3):38–42.
87.
Zhan J, Chen Q. Investigation and analysis of the application condition of antibacterial agents on hospitalization children in our hospital. Nei Mongol J Tradit Chin Med. 2013;32(18):96–7.
88.
89.
Yao Q, Luo Z. Clinical application of antibiotic in department of pediatrics. Chin J Clin Ration Drug Use. 2014;15:1–2.
90.
Wu M, Chen Y, Wu X. Investigation of pediatric medical records and analysis of antimicrobial drug application in a certain hospital. J Navy Med. 2014;4:260–2.
91.
Zhu G, Wu X. Antibiotics usage analysis in pediatric inpatients. J Modern Med Health. 2014;30(21):3239–40.
92.
Liu Y. Survey and analysis of the use of antibacterials in pediatric inpatients of our hospital. China Licensed Pharmacist. 2014;11(11):13–5.
93.
Huang W. Analysis of the use of antibiotic in our hospital in 2013 were from January to December in pediatrics. China Health Ind. 2014;11(21):35–6.
94.
Huang G, Miao D, Lai X, et al. Investigation of use of antibiotics by hospitalized neonates. Chin J Nosocomiol. 2014;24(01):97–8.
95.
Cheng X, Yan X, Lin S. The Investigation and analysis of antimicrobial drugs used by 258 pediatric inpatients. J Hubei Univ Nationalities Med Ed. 2014;31(02):40–1.
96.
Cheng H, Wu D. Survey of antimicrobial agents use in pediatric inpatients. Chin J Pharmaco Epidemiol. 2014;23(12):737–40.
97.
Chen Y, Ye J. Pharmaceutical intervention on the use of antibiotics in the neonatology of X-hospital. China Health Ind. 2015;16:12–4.
98.
Li L, Xu H, Zhou J, et al. Application effect of clinical pathway management in infantile capillary bronchitis and the impact on antibiotics utilization ratio. Chin J Clin Ration Drug Use. 2017;10(12):35–6 41.
99.
Su X, Zhu H, Yuan H. Analysis of antibiotic use for bronchial pneumonia in pediatrics. J Kunming Med Univ. 2017;38(7):126–9.
100.
Zhu J, Luo M, Li L, et al. Promotion of PDCA cycle on rational usage of antibiotics in neonatal department. J Guangdong Pharmaceut Univ. 2017;33(5):649–53.
101.
Li R, Zhang J, Li G. Analysis of clinical antibiotic use and adverse reactions in pediatrics. Chin Nurs Res. 2018;32(23):3815–7.
102.
Chen Z, Xiao Y. Analysis on usage of antibacterial drugs in inpatient children of Tianjin Children’s Hosptial in 2016. Drugs Clinic. 2018;33(03):672–5.
103.
Zhang JS, Liu G, Zhang WS, et al. Antibiotic usage in Chinese children: a point prevalence survey. World J Pediatr. 2018;14(4):335–43.PubMedCrossRef
104.
Ju J. Study on the effect of pharmacist intervention on rational use of pediatric antibiotics. China Foreign Med Treat. 2019;38(7):127–9.
105.
Wei W, Wang XF, Liu JP, et al. Status of antibiotic use in hospitalized children with community-acquired pneumonia in multiple regions of China. Chin J Contemp Pediatr. 2019;21(1):11–7.
106.
Niu J. Analysis on the treatment and intervention of pediatric upper respiratory tract infection in hospital. Chin Community Doctors. 2020;36(16):18.
107.
Miao R, Wan C, Wang Z, et al. Inappropriate antibiotic prescriptions among pediatric inpatients in different type hospitals. Medicine (Baltimore). 2020;99(2):e18714.CrossRef
108.
Zhang M, Ma XY, Feng ZQ, et al. Survey of antibiotic use among hospitalised children in a hospital in Northeast China over a 4-year period. J Spec Pediatr Nurs. 2020;25(2):e12282.PubMedCrossRef
109.
Wei X, Zhang Z, Hicks JP, et al. Long-term outcomes of an educational intervention to reduce antibiotic prescribing for childhood upper respiratory tract infections in rural China: Follow-up of a cluster-randomised controlled trial. PloS Med. 2019;16(2):e1002733.PubMedPubMedCentralCrossRef
110.
Cui F, Yuan Y, Cui H, et al. A survey on the knowledge of antibiotics of children parents in three children-hospitals of Beijing. Chin J Med. 2015;8:67–70.
111.
Zhao M, Nan W, Jiao X, et al. Survey on the parent situation of antibacteriol drugs use for children. Northwest Pharmaceut J. 2016;31(02):200–2.
112.
Yin Y, Cui N. Antibiotics use among preschool children and parental cognition in Ji’nan city. Chin J Public Health. 2018;34(1):118–20.
113.
Peng D, Zhou X. Parents’ antibiotic use for children in Ningbo: knowledge, behaviors and influencing factors. J Zhejiang Univ. 2018;47(2):156–62.
114.
Yao Z, Zhou J, Li Y, et al. Prevalence of self-medication with antibiotics in kindergarten children of Guangzhou city. Chin J Public Health. 2013;29(10):1485–7.
115.
Miao R. Investigation on the impact of parents’ cognitive level of antibiotics on self-directed use of antibiotics in pupils. Pract Prev Med. 2013;20(1):42–5.
116.
Zhang G, Cao L, Yuan Y. 10 years’ changes on parent’s antibiotic knowledge in Beijing. Chin J Med. 2014;10:41–4.
117.
Yu M, Zhao G, Stålsby LC, et al. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. Bmc Infect Dis. 2014;14:112.PubMedPubMedCentralCrossRef
118.
Ding L, Sun W, Li Y, et al. Studying on the status of rural parents’ cognition on antibiotics and its influencing factors. Chin Health Serv Manage. 2016;33(2):111–4.
119.
Cen Q, Dai D. The relationship between novice mother and neonates in use of antibiotic cold medications and the effects of health education. Drug Eval. 2016;13(21):47–50.
120.
Zhang Z, Zhan X, Zhou H, et al. Antibiotic prescribing of village doctors for children under 15 years with upper respiratory tract infections in rural China: A qualitative study. Medicine (Baltimore). 2016;95(23):e3803.CrossRef
121.
Cheng YC, Pan YP, Zhang Y, et al. Investigation of the cognition and behavior on drug safety in Beijing middle school students. Beijing Da Xue Xue Bao Yi Xue Ban. 2017;49(6):1038–43.PubMed
122.
Chang J, Lv B, Zhu S, et al. Non-prescription use of antibiotics among children in urban China: a cross-sectional survey of knowledge, attitudes, and practices. Expert Rev Anti Infect Ther. 2018;16(2):163–72.PubMedCrossRef
123.
Fan W, Mu J, Song X, et al. Investigation on antibiotic cognition and use of parents of preschool children in Tianjin. Chin Prim Health Care. 2019;33(4):61–2.
124.
Ge Y, Chipenda DS, Liao XP. Advanced neonatal medicine in China: Is newborn ward capacity associated with inpatient antibiotic usage? PloS One. 2019;14(8):e219630.CrossRef
125.
Cheng J, Chai J, Sun Y, et al. Antibiotics use for upper respiratory tract infections among children in rural Anhui: children’s presentations, caregivers’ management, and implications for public health policy. J Public Health Policy. 2019;40(2):236–52.PubMedCrossRef
126.
Wang J, Sheng Y, Ni J, et al. Shanghai parents’ perception and attitude towards the use of antibiotics on children: A cross-sectional study. Infect Drug Resist. 2019;12:3259–67.PubMedPubMedCentralCrossRef
127.
Ye D, Yan K, Zhang H, et al. A survey of knowledge, attitudes and practices concerning antibiotic prescription for upper respiratory tract infections among pediatricians in 2018 in Shaanxi Province, China. Expert Rev Anti Infect Ther. 2020;18(9):927–36.PubMedCrossRef
128.
Wei X, Deng S, Haldane V, et al. Understanding factors influencing antibiotic prescribing behaviour in rural China: a qualitative process evaluation of a cluster randomized controlled trial. J Health Serv Res Policy. 2020;25(2):94–103.PubMedCrossRef
129.
Zhang J, Cameron D, Quak SH, et al. Rates and determinants of antibiotics and probiotics prescription to children in Asia-Pacific countries. Beneficial Microbes. 2020;11(4):329–38.PubMedCrossRef
130.
Wang J, Huang C, Li Z, et al. Knowledge and behavior of antibiotic use for upper respiratory tract infection among parents of young children in Changsha city. Chin J Public Health. 2017;33(3):415–8.
131.
Zhang Y, Lin S, Li G, et al. Cognition and usage of antibiotics in caregivers of 0-6 years old children in the rural area of Weinan City, 2015. Pract Prev Med. 2017;24(2):196–8.
132.
Li W, Lu Y, Chen M, et al. Meta-analysis on Antibiotics Usage in Children with Upper Respiratory Tract Infection in China. Chin Pharmaceut J. 2017;52(10):880–5.
133.
Department of Health MoH. National antimicrobial drug clinical application special rehabilitation program (Excerpt). Chin Community Physician (Medical). 2012;14:8.
134.
Poole NM, Shapiro DJ, Fleming-Dutra KE, et al. Antibiotic prescribing for children in United States emergency departments: 2009-2014. Pediatrics. 2019;143:2.CrossRef
135.
Kumar R, Goyal A, Padhy BM, et al. Self-medication practice and factors influencing it among medical and paramedical students in India: A two-period comparative cross-sectional study. J Nat Sci Biol Med. 2016;7(2):143–8.PubMedPubMedCentralCrossRef
136.
Zhao H, Bian J, Han X, et al. Outpatient antibiotic use associated with acute upper respiratory infections in China: a nationwide cross-sectional study. Int J Antimicrob Agents. 2020;56(106193).
137.
Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;2:D6895.
138.
139.
Sun Q, Dyar OJ, Zhao L, et al. Overuse of antibiotics for the common cold - attitudes and behaviors among doctors in rural areas of Shandong Province, China. BMC Pharmacol Toxicol. 2015;16:6.PubMedPubMedCentralCrossRef
140.
Yin J, Dyar OJ, Yang P, et al. Pattern of antibiotic prescribing and factors associated with it in eight village clinics in rural Shandong Province, China: a descriptive study. Trans R Soc Trop Med Hyg. 2019;113(11):714–21.PubMedCrossRef
141.
Ma S, Huang Y, Yang Y, et al. Prevalence of burnout and career satisfaction among oncologists in China: A national survey. Oncologist. 2019;24(7):e480–9.PubMedCrossRef
142.
Yin J, Wei X, Li H, et al. Assessing the impact of general practitioner team service on perceived quality of care among patients with non-communicable diseases in China: a natural experimental study. Int J Qual Health Care. 2016;28(5):554–60.PubMedCrossRef
143.
Kunin CM, Tupasi T, Craig WA. Use of antibiotics. A brief exposition of the problem and some tentative solutions. Ann Intern Med. 1973;79(4):555–60.PubMedCrossRef
144.
Wang J, Wang P, Wang X, et al. Use and prescription of antibiotics in primary health care settings in China. Jama Intern Med. 2014;174(12):1914–20.PubMedCrossRef
145.
McKay R, Mah A, Law MR, et al. Systematic review of factors associated with antibiotic prescribing for respiratory tract infections. Antimicrob Agents Chemother. 2016;60(7):4106–18.PubMedPubMedCentralCrossRef
146.
Togoobaatar G, Ikeda N, Ali M, et al. Survey of non-prescribed use of antibiotics for children in an urban community in Mongolia. Bull World Health Organ. 2010;88(12):930–6.PubMedPubMedCentralCrossRef
147.
Grigoryan L, Burgerhof JG, Degener JE, et al. Attitudes, beliefs and knowledge concerning antibiotic use and self-medication: a comparative European study. Pharmacoepidemiol Drug Saf. 2007;16(11):1234–43.PubMedCrossRef
148.
Coxeter PD, Mar CD, Hoffmann TC. Parents’ expectations and experiences of antibiotics for acute respiratory infections in primary care. Ann Family Med. 2017;15(2):149–54.CrossRef
149.
Sun X, Jackson S, Carmichael GA, et al. Prescribing behaviour of village doctors under China’s New Cooperative Medical Scheme. Soc Sci Med. 2009;68(10):1775–9.PubMedCrossRef
150.
Zeru T, Berihu H, Buruh G, et al. Parental knowledge and practice on antibiotic use for upper respiratory tract infections in children, in Aksum town health institutions, Northern Ethiopia: a croos-sectional study. Pan Afr Med J. 2020;35:142.PubMedPubMedCentralCrossRef
151.
El-Hawy RM, Ashmawy MI, Kamal MM, et al. Studying the knowledge, attitude and practice of antibiotic misuse among Alexandria population. Eur J Hosp Pharm. 2017;24(6):349–54.PubMedCrossRef
152.
Connelly J. Critical realism and health promotion: effective practice needs an effective theory. Health Educ Res. 2001;16(2):115–9.PubMedCrossRef
153.
Sun C, Hu YJ, Wang X, et al. Influence of leftover antibiotics on self-medication with antibiotics for children: a cross-sectional study from three Chinese provinces. Bmj Open. 2019;9(12):e33679.CrossRef
154.
Jin C, Ely A, Fang L, et al. Framing a global health risk from the bottom-up: User perceptions and practices around antibiotics in four villages in China. Health Risk Soc. 2011;13(5):433–49.CrossRef
155.
156.
Gong Y, Jiang N, Chen Z, et al. Over-the-counter antibiotic sales in community and online pharmacies, China. Bull World Health Organ. 2020;98(7):449–57.PubMedPubMedCentralCrossRef
157.
158.
He D. 877 example young child acute under respiratory tract infects in hospital trouble clinical analysis. Chin Manipulation Rehabil Med. 2011;8:97.
159.
Xie H, Zhou J, Liu F. Paediatric antibiotic use and monitoring of common bacterial resistance. Chin J Ethnomed Ethnopharm. 2011;20(9):8 10.
160.
Wu J. The Analysis of utilization of antibiotics in children with respiratory tract infection. Guide China Med. 2012;10(11):31–2 35.
Metadata
Title
Prevalence and risk factors for antibiotic utilization in Chinese children
Authors
Shasha Guo
Qiang Sun
Xinyang Zhao
Liyan Shen
Xuemei Zhen
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Antibiotic
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-021-02706-z

Other articles of this Issue 1/2021

BMC Pediatrics 1/2021 Go to the issue

Research

Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia

Research article

The effect of inhaling mother’s breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial

Research

Leflunomide therapy for IgA vasculitis with nephritis in children

Research article

Preconceptional and prenatal exposure to diurnal temperature variation increases the risk of childhood pneumonia

Research

Colorectal Cancer associated with pediatric inflammatory bowel disease: a case series

Case report

A Chinese patient with developmental and epileptic encephalopathies (DEE) carrying a TRPM3 gene mutation: a paediatric case report