[An analysis of the use of antibacterial drugs in pediatric in-patients in Department of Oral and Maxillofacial Surgery].

PURPOSE: To investigate the status of administration of antibiotics drugs for pediatric in-patients in the Department of Oral and Maxillofacial Surgery in our hospital and offer guides for rational use of antibiotics in clinical practice. METHODS: 102 medical records of children from 3 months to 18 years in the Department of Oral and Maxillofacial Surgery in our hospital from the year of 2005-2006 were selected randomly. They were required to fill in the questionnaire which included gender, age, diagnosis of diseases, situation of medicine, laboratory examination, bacterial culture and sensitivity test of medicine. Respective analysis was done over the aspects of the variation of antibiotics medication, duration of medication, drug combination, various choices of antibiotics during the treatment and the ways of administration. A conclusion was drawn of whether the administration of antibiotics was rational. RESULTS: The rate of antibiotics administration was 94.12%, and the rates of single drug and combined administration (two drugs) were 74.51% and 19.61% respectively. Intravenous drip was the main way of administration, 54 cases received antibiotics orally, none of them received intramuscular medication. The rate of changing two kinds of antibiotics,three kinds of antibiotics and four kinds of antibiotics were 36.27%,23.53% and 9.8% respectively. The rate of bacterial culture was 1.96%. The rate of duration of medication in less than three days, from three days to seven days and more than seven days were 24.50%,48.04% and 21.57% respectively. The administration frequence was higher in cephalosporins, lincosamides, penecillins category than in other antibiotics. CONCLUSION: Rational use of anti-bacteria drugs was the main trend, however some problems still existed such as prophylactic administration of antibiotics, low delivery ratio of sample collection, irrational use of drugs, frequent change of antibiotics and drug abuse etc. Therefore, more efficient measures should be developed and implemented such as rational layout of wards, enhancing preoperative health care and rational administration of antibiotics etc.

[Clinical evaluation for sublingual immunotherapy of allergic asthma and atopic rhinitis with Dermatophagoides Farinae Drops].

OBJECTIVE: To evaluate the safety and efficacy of sublingual immunotherapy with 'Dermatophagoides Farinae Drops' in D. farinae allergic asthma and/or rhinitis patients. METHODS: A 25-week double-blind, placebo-controlled, multi-centered trail was conducted in 278 children (aged 4 - 18 yr) with mite-induced asthma and/or rhinitis. Patients were randomly assigned to receive sublingual immunotherapy (SLIT) with 'Dermatophagoides Farinae Drops' (n = 139) or placebo (n = 139) for 25 weeks and the dosage and administration strictly followed the manufacturer's instructions. At the beginning of the 2nd, 3rd, 4th, 6th, 10th, 14th, 18th, 22nd week of the treatment, the patients were asked to accept follow-up visit, during the clinical trial all patients and parents were asked to keep a daily record of their asthma symptom scores, rescue medicine use, rhinitis symptom scores, morning and evening peak expiratory flow. Asthma symptom scores, reduction in use of rescue medicine, rhinitis symptom scores, lung function tests, skin sensitivity to mite, mite-specific immunoglobulin (Ig) E and IgG4, and quality of life and adverse effect were assessed during the study. RESULT: (1) Of the 278 children, 27 dropped out before the study completion. (2) After 25 weeks of treatment, the median variability of PEFR was -1.38 for SLIT group and -0.90 for the placebo (P < 0.05). (3) Besides, the mean variability of medicine score of asthma was -0.08 for SLIT group and 0.52 for the plcebo (P < 0.05). (4) The median variability of rhinitis symptom score was -1.96 for SLIT group and -1.03 for the placebo (P < 0.01). (5) The rescue medicine usage of SLIT reduced but did not show significant differences between SLIT and placebo. (6) After 25 weeks treatment, the increase of D. farinae specific IgE antibody of two groups were similar, while specific IgG4 increased significantly in SLIT compared to the patients in control one (P < 0.01); (7) No severe adverse events happened in the trial and the most-likely adverse events were mild asthma and local rash. CONCLUSION: Dermatophagoides Farinae Drops is safe and effective in treating allergic asthma and atopic rhinitis.