Descrição do uso de antibióticos em infecções respiratórias agudas em pacientes menores de 4 anos internados em um hospital

Abstract

Background: Acute respiratory infection (ARI) is a persistent public health problem in several countries, especially in developing countries, as it is an important cause of death in children (Li et al, 2021). Methodology: A retrospective cohort study was carried out, in which records of hospitalizations at Hospital Santo Antônio for children under 4 years of age in 2019 were studied. The nursing record book containing the patient's name, medical record number and hospitalization diagnosis was analyzed. The data researched were: sex (female or male), dates of birth, hospitalization, discharge, runny nose, cough, nasal obstruction, fever reported by the guardian, vomiting, diarrhea, rash, difficulty breathing, cyanosis, comorbidity, use of corticosteroids , use and suspension of antibiotics, bronchodilators, outcome (discharge, transfer, death).. Result: 494 medical records were included in the study, 22 medical records were excluded due to erroneous registration in the nursing record book. In none of the records analyzed did the patients die. Of the 472 medical records included in the study, the majority of children were less than 1 year old 269 (57%) and there were more male patients 254 (53.8%) than female 218 (46.2%), the time average length of stay was 5.9 days ((25% percentile 2.2 days and 75% percentile 7 days). The most prevalent symptoms were cough (366;77.5%), fever (294;62.3%), difficulty breathing (278;58.9%). The least frequent symptoms were rash (4;0.8% ), odynophagia (4;0.8%), cyanosis (6;1.3%). When prescribed, the most used antibiotics upon hospital admission were crystalline penicillin (65; 13.8%), ceftriaxone (50; 10.6%), amoxicillin with clavulonate (37; 7.8%). Antibiotic suspension was observed in 123 medical records. The most frequently suspended antibiotic was ceftriaxone (85.18%), followed by azithromycin (14.3%), crystalline penicillin (11.2.3%). The suspension of bronchodilators (151;31.8%) and corticosteroids (159;33.7%) was also observed. Discussion: The results presented draw attention to the excessive use of antibiotics, since the main etiological agent of HAIs are viral infections. The antibiotic most suspended upon hospital admission was ceftriaxone, this data may reflect the excessive use of this as it is not the first choice in the treatment of respiratory infections, with penicillins prevailing