Abstract:

Objective　To explore the effect of the PDCA (plan, do, check, and act) cycle method on rational application of antibiotics in pediatric inpatients with infections. Methods　This was a cohort study. One hundred and fifty-six inpatients with infections treated at Department of Pediatrics, Hongyang Town Health Center from January to June 2023 were selected as a control group, and 164 inpatients with infections from July to December 2023 an experimental group. In the control group, there were 82 boys and 74 girls; they were (2.40±0.82) years old; there were 79 cases of respiratory tract infections, 38 cases of digestive tract infections, and 39 cases of other infections. In the experimental group, there were 89 boys and 75 girls; they were (2.35±0.93) years old; there were 85 cases of respiratory tract infections, 33 cases of digestive tract infections, and 46 cases of other infections. The control group used antibiotics according to the routine pediatric process. The experimental group improved the application of antibiotics for the children by the PDCA cycle method. The antibiotic use rates, the rates for using ≥2 antibiotics, hospitalization times, proportions of antibiotic cost to hospitalization cost, and incidence rates of antibiotic complications (rash and antibiotics-associated diarrhea) were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The antibiotic use rate, the rate for using ≥2 antibiotics, and proportion of antibiotic cost to hospitalization cost in the experimental group were lower than those in the control group [44.51% (73/164) vs. 66.03% (103/156), 34.14% (56/164) vs. 57.05% (89/156), and 18.19% vs. 40.17%; χ²=14.95, 20.64, and 19.52; all P<0.05]. The hospitalization time in the experimental group was shorter than that in the control group [(6.98±2.76) d vs. (13.01±4.35) d; t=14.06; P<0.05]. The incidence rates of rash and antibiotics-associated diarrhea in the experimental group were lower than those in the control group [27.43% (45/164) vs. 48.71% (76/156) and 19.51% (32/164) vs. 43.58% (68/156); χ²=18.50 and 24.73; both P<0.05]. Conclusion　The PDCA cycle method can improve the the rational use of antibiotics for pediatric inpatients with infections.

Key words:

Antibiotics, PDCA cycle method, Pediatrics

摘要：

目的　探讨PDCA［plan（计划）、do（执行）、check（检查）和act（处理）］循环法对儿科感染住院患儿抗生素合理使用的效果。方法　本研究为队列研究。将2023年1月至6月在普宁市洪阳镇中心卫生院儿科治疗的感染住院患儿156例设为对照组，将2023年7月至12月在普宁市洪阳镇中心卫生院儿科治疗的感染住院患儿164例设为试验组。对照组男82例，女74例，年龄（2.40±0.82）岁；疾病构成：呼吸道感染79例，消化道感染38例，其他感染39例。试验组男89例，女75例，年龄（2.35±0.93）岁；疾病构成：呼吸道感染85例，消化道感染33例，其他感染46例。对照组按儿科既往抗生素使用流程常规治疗。试验组采用PDCA循环法对住院患儿的抗生素使用进行改进。比较两组抗生素使用率、两联及以上抗生素使用率、住院时间、抗生素费用占住院费用比例以及抗生素并发症（皮疹及抗生素相关性腹泻）发生率。采用t检验、χ²检验进行统计分析。结果　试验组抗生素使用率低于对照组［44.51%（73/164）比66.03%（103/156），χ²=14.95，P<0.05］。试验组两联及以上抗生素使用率低于对照组［34.14%（56/164）比57.05%（89/156），χ²=20.64，P<0.05］。试验组抗生素费用占住院费用比例低于对照组（18.19%比40.17%，χ²=19.52，P<0.05）。试验组住院时间短于对照组［（6.98±2.76）d比（13.01±4.35）d，t=14.06，P<0.05］。试验组皮疹、抗生素相关性腹泻发生率均低于对照组［27.43%（45/164）比48.71%（76/156）、19.51%（32/164）比43.58%（68/156），χ²=18.50、24.73，均P<0.05］。结论　PDCA循环法可促进儿科感染住院患儿抗生素的合理使用。

关键词:

抗生素, PDCA循环法, 儿科