medigraphic.com
SPANISH

Revista Médica del Instituto Mexicano del Seguro Social

  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2010, Number 6

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2010; 48 (6)

Therapeutic conduct in children attended in emergency room during the epidemic of influenza A H1N1

Rendón-Macías ME, Hernández-Romano FA, Iglesias-Leboreiro J, Bernardez-Zapata I
Full text How to cite this article

Language: Spanish
References: 15
Page: 607-614
PDF size: 45.16 Kb.


Key words:

influenza A virus H1N1 subtype, antiviral agents, anti-bacterial agents, drugs prescriptions, child.

ABSTRACT

Objective: to analyze the prescription of antiviral and antibiotic agents in children with upper airway infection (UAI) during Influenza H1N1 epidemic.
Methods: a cross-section study (01/04/2009 to 31/ 03/2010) was performed. We analyzed the antiviral and antibiotic agents’ prescription and its relation with the presence of the triad of symptom of suspicion (migraine, fever and cough) and the cost for attention (medicines and screening test).
Results: 838 children were attendance for UAI, 40.3 % with the suspicion triad. In 733 patients, the screening test were done with 155 positive results (120 had the triad). All patient with a positive result received oseltamivir. During the first five months of the epidemic, the medical prescriptions were: antibiotics 60-85 %, 0-7 % anti-viral and 20-30 % symptomatic drug´s. At the 6th at 8th months (peak of outbreak) antibiotics 35-70 %, anti-virals 20-25 % and 10-30 % symptomatic drug´s. At final months (9th to 11th) antimicrobials 65-80 %, antivirals 20-30 % and symptomatic 0-10 %. The cost for URI attention increased a 27 %.
Conclusions: medical prescription changed during the epidemic, with an increased in the antivirals, especially for patients with high suspicion for influenza and positive screening test.


REFERENCES

  1. Low D. Reducing antibiotic use in influenza: challenges and rewards. Clin Microbiol Infect 2008;14 (4):298-306.

  2. Rothberg MB, Fisher D, Kelly B, Rose DN. Management of influenza symptoms in healthy children: cost-effectiveness of rapid testing and antiviral therapy. Arch Pediatr Adolesc Med 2005; 159(11):1055-1062. Disponible en http://archpedi. ama-assn.org/cgi/reprint/159/11/1055

  3. American Academy of Pediatrics Committee on Infectious Diseases. Antiviral therapy and prophylaxis for influenza in children. Pediatrics 2007; 119(4):852-860. Disponible en http://pediatrics. aappublications.org/cgi/reprint/119/4/852

  4. Friedman MJ, Attia MW. Clinical predictors of influenza in children. Arch Pediatr Adolesc Med 2004;158(4):391-394. Disponible en http:// archpedi.ama-assn.org/cgi/reprint/158/4/391

  5. Jennings LC, Skopnik H, Burckhardt I, Hribar I, Del Piero L, Deichmann KA. Effect of rapid influenza testing on the clinical management of paediatric influenza. Influenza Other Respir Viruses 2009;3(3):91-98.

  6. Bonner AB, Monroe KW, Talley LI, Klasner AE, Kimberlin DW. Impact of the rapid diagnosis of in fluenza on physician decision-making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics 2003;112(2):363-367. Disponible en http://pediatrics.aappublications.org/cgi/reprint/ 112/2/363

  7. Mitamura K, Sugaya N. Diagnosis and treatment of influenza—clinical investigation on viral shedding in children with influenza. Uirusi 2006;56(1):109-116.

  8. Uyeki TM. Influenza diagnosis and treatment in children: a review of studies on clinically useful test and antiviral treatment for influenza. Pediatr Infect Dis J 2003;22(2):164-177.

  9. Pierron S, Haas H, Berlioz M, Ollier L, Albertini M. Impact of rapid influenza test during influenza epidemic in all febrile children less than 6 years old in a pediatric emergency department. Arch Pediatr 2008;15(8):1283-1288.

  10. Instituto Mexicano del seguro Social. Guía de práctica clínica, prevención, diagnóstico y tratamiento de la influenza A H1N1. México: Instituto Mexicano del seguro Social; 2009. Disponible en http:// www.imss.gob.mx/NR/rdonlyres/037AA1E9-530E- 4E8B-882F-F8B6EA1D3233/0/GPC_InfluenzaA H1N117092009.pdf

  11. Shun-Shin M, Thompson W, Heneghan C, Perera R, Harnden A, Mant D. Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomized controlled trials. BMJ 2009;339:b3172. Disponible en http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC2724601/pdf/bmj.b3172.pdf

  12. Balfour HH Jr, Englund J. Antiviral drugs in pediatrics. Am J Dis Child 1989;143(11):1307-1316.

  13. Jofré L. Tratamiento y profilaxis de influenza estacional en niños. Neumol Pediatr 2009;4(1):29-34. Disponible en http://www.neumologia-pediatrica. cl/pdf/200941/200941.pdf#page=35

  14. Echeverría-Zuno S, Mejía-Aranguré J, Mar-Obeso J, Grajales-Muñiz C, Robles-Pérez E, González- León M, et al. Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis. Lancet 2009;374:2072-2079.

  15. Laguna-Torres VA, Benavides JG. Infection and death from influenza A H1N1 virus in Mexico. Lancet 2009;374(9707):2072-2079.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Med Inst Mex Seguro Soc. 2010;48