Rational use of antibiotics in paediatrics to reduce adverse effects

IntroductionAntibiotics play an important role in the treatment of paediatric diseases, and the rational use of antibiotics can effectively counter bacterial infections and save the lives of countless children. However, with the widespread use of antibiotics, the incidence of overdoses, overspeculation and over-therapeutic application of antibiotics is increasing, resulting in an adverse effect on the affected children. It can affect the current state of health of the infected child and negatively affect its long-term growth and development. Therefore, it is a high priority for the field of paediatric medicine to explore strategies for the rational use of antibiotics to reduce the incidence of adverse effects.II. Current situation of unjustified use of antibiotics in paediatrics(i) Overdose useIn paediatric clinics, some doctors may inadvertently increase the dose of antibiotics in pursuit of rapid treatment. For example, in the treatment of pneumonia in children, it may take some time at normal doses to see the obvious effects of some antibiotics, but doctors may fear a deterioration of the condition and increase the dose. Such overdose can lead to serious gastrointestinal responses, such as nausea, vomiting, diarrhoea, etc., and may cause damage to the liver and kidney function of the affected child.(ii) Use of excess specificationsThe overspecified use is mainly reflected in the use of antibiotics that are not suitable for the age, weight or severity of the child. In some hospitals, there may be limited choice of specifications for medicines, and doctors can only choose close but not entirely appropriate specifications to prescribe them. For example, for infants and young children, some adult-specified antibiotics are difficult to control accurately at doses when used separately, and are vulnerable to dose errors and increased risk of adverse effects. In addition, some doctors may not have fully taken into account the specific physiological characteristics of the child and have opted for specifications for antibiotics that have a high toxic side effect on children.(iii) Use of ultratherapyThe use of antibiotics over-the-horizon is also common due to the complexity of paediatric diseases and the disproportionate concern of parents about their condition. When the symptoms of a child ‘ s illness are slightly reduced but not fully recovered, the doctor may continue to extend the use of antibiotics, or parents may continue to give the patient their own medication. The long-term use of antibiotics can disrupt the micro-ecological balance of the infected child, leading to herb-commodity disorders and secondary infections such as goose scabies and diarrhoea, while increasing the likelihood of bacterial resistance.III. Hazards resulting from adverse reactions due to the unjustified use of antibiotics in paediatrics(i) Impact on child growth and development1. Skeletal abnormalitiesThe long-term and unreasonable use of certain antibiotics, such as tetracyclics, can form a stable complex with calcium, deposited in bones and teeth and influence the normal development of bones. For children at high growth and development levels, this can lead to slow growth of bones, color change of teeth, poor development of the teeth, and negative effects on their appearance and physical functioning.2. Impacts on nervous system developmentInappropriate use of aminocin antibiotics can cause damage to the hearing nerve and kidneys of children. Especially for infants, whose nervous system and kidney functions are not yet fully mature, drugs are more likely to accumulate in these areas, causing hearing problems such as reduced hearing, ringing, etc., and severe can lead to deafness, which may also affect normal kidney excretion and thus overall growth and development.(ii) Increased bacterial resistanceUnreasonable use of antibiotics would allow bacteria to evolve in a high-pressure pharmaceutical environment and create resistance mechanisms. In paediatrics, common pathogens such as pneumocococcus, yellow grapes, etc. are gradually becoming resistant to a variety of antibiotics as a result of frequent exposure to overdoses and antibiotics. This makes the follow-up treatment of these bacterial infections more difficult, increases the cost of treatment and the suffering of the sick, and may even lead to some serious infections that are unmedicated.(iii) Inducing allergiesOverdoses and over-specified use of antibiotics increase the risk of a child being allergic. Antibiotic allergies can be manifested in skin symptoms such as rashes, itchings and measles, with allergies in the severe. The immune system for children is not yet perfect, the resistance to drugs is poor, and, if responsive, it can rapidly develop into a serious, systemic response that endangers life.IV. Strategies for the rational application of antibiotics in paediatrics(i) Accurate diagnosis and rigorous documentation of adaptation1. Increasing the level of diagnosisPaediatricians should use a combination of clinical symptoms, signs, laboratory tests, etc. for the accurate diagnosis of diseases. For example, antibiotics should not be used blindly on the basis of the symptoms of heat, but should be examined further for evidence of bacterial infections, such as changes in white cell count, C-reacting indicators such as protein, calcium reduction, and the presence of local infection stoves. Antibiotics are ineffective and should be avoided in cases of fever caused by viral infections, such as common colds.2. Compliance with drug guidelinesThe use of antibiotics is strictly determined in accordance with the guidelines for paediatric treatment and for the use of antibiotics. In the case of some mild infections, such as mild respiratory infections, there is no clear evidence of bacterial infections, first accommodative treatment can be used to observe changes. For specific bacterial infections, suitable antibiotics are selected according to the type of pathogens infected, the area of infection and the severity of the condition.(ii) Selection of suitable antibiotics according to the characteristics of the child1. Age considerationsChildren of different ages have different tolerance and metabolism for different antibiotics. For example, the use of chlorocin should be avoided in newborns, where hepato-renal function is not yet mature and where metabolism of chlorocin is slow and prone to grey baby syndrome. In the case of infections common in childhood, e.g. mid-earitis, nasal inflammation, etc., the choice should be made of antibiotics that are sensitive to the pathogen and are highly safe, e.g., Amosilin-Klave acid.2. Combining weight countAccurate weight calculation of the affected child is key to the rational use of antibiotics. Doctors should use appropriate weight formulas and determine the use of antibiotics based on the actual weight of the infected child. For obese or wasting children, further dose adjustments may be required. At the same time, in the use of some antibiotics requiring weight-adjusted doses, such as vancocin, the dose is strictly measured by weight and blood concentrations are monitored to ensure the safety and effectiveness of the treatment.(iii) Reasonable determination of course of treatment1. Adapting treatment to medical conditionsFor acute infections, such as acute tonsilitis, there is usually a 3 to 5-day stoppage of the disease after the child ‘ s temperature is normal and symptoms are reduced. In the case of some chronic or serious infections, such as osteoporosis, sepsis, etc., treatment needs to be extended, as appropriate, depending on the elimination of the pathogens, the immunisation status of the infected child, etc., while avoiding unnecessary long-term use of medication. In the course of treatment, changes in the condition of the child are closely observed and laboratory indicators, such as blood protocol, C reaction protein, etc., are periodically reviewed to guide the adjustment of the treatment.2. Avoiding parental self-abuse or prolonged useDoctors are required to explain in detail to parents the methods of use and treatment of antibiotics, and to advise parents not to stop or increase their time. At the same time, parents can be made aware of the dangers of irrational use of medicines, including through awareness-raising campaigns.V. Strengthening the regulation of the use of paediatric antibiotics(i) Hospital internal management1. Establishment of an antibiotic use monitoring systemHospitals should have well-developed antibiotic use monitoring systems to monitor the use of paediatric antibiotics in real time, including the use of varieties, dosages, treatment programmes, information on the sick and the sick. Large data analysis allows for the timely detection of overdoses, overspeculations, over-therapeutic use of antibiotics and feedback to relevant clinics and doctors to adjust treatment programmes in a timely manner.2. Implementation of a prescription point assessmentPeriodic pediatric antibiotics prescription point evaluations are conducted, and experts are organized to review the prophylactic prescriptions issued by paediatricians. Emphasis is placed on examining the reasonableness of the probative, dosage, specification, treatment, etc. of the antibiotics in the prescription, and on analysing and providing feedback on unreasonable prescriptions, and on encouraging doctors to improve them. At the same time, the results of the prescription point evaluation are linked to the doctor ‘ s performance appraisal, and the doctor ‘ s awareness of the rational use of medicines is raised.(ii) Industrial regulation1. Developing strict norms and standardsThe health administration should further refine the norms and standards for the rational use of paediatric antibiotics by clearly defining the different age groups, the principles of the use of antibiotics in different cases of disease, the dose range, the treatment process, etc. At the same time, the examination and monitoring of the use of antibiotics in paediatric medical institutions is being strengthened, and medical institutions and doctors who use antibiotics in violation of the law are punishable by law.2. Strengthening training and educationTraining and education activities on the rational use of antibiotics for paediatricians are ongoing, and the doctor ‘ s knowledge structure is continuously updated to improve its level of rational use. The training could include new antibiotic pharmacological knowledge, drug resistance monitoring, case analysis of rational use, etc. At the same time, the pediatrician can be provided with a platform for learning and communication through academic meetings, web courses, etc.ConclusionsThe rational use of antibiotics in paediatrics is essential to safeguard the health of children with disabilities and to reduce adverse effects. The problem of overdose, overspeculation and over-therapeutic use of antibiotics still exists in paediatric medicine, with serious risks for the growth and development of the infected child, bacterial resistance and allergies. A range of measures, such as accurate diagnosis, rational choice of antibiotics, identification of appropriate treatments and improved supervision, can effectively improve the rational use of paediatric antibiotics, reduce the incidence of adverse reactions and create good conditions for the improvement of the quality of paediatric care and the healthy development of the sick. At the same time, a concerted effort by society as a whole, including doctors, parents, medical institutions and health administrations, is required to work together to ensure that the rational use of paediatric antibiotics is addressed and promoted.