MANAGEMENT OF AE-CB/COPD: A SURVEY OF RESPIRA- TORY PHYSICIANS IN SOME REGIONS OF CHINA

摘要

Objective To investigate the bacteria spectrum isolated from AE-CB/COPD and the manner of management of AE-CB/COPD in respiratory or internal medicine department in some regions of China. Methods Respiratory physicians received questionnaire at randomization just after they managed a patient presenting to outpatient department with AE-CB/COPD, on general conditions and symptoms of patients, type of examinations, diagnosis, type of antibiotics used and mode of administration. Results of sputum bacteria culture were followed up. Results Among the 1583 AE-CB/COPD, 63. 04% were male and 35. 19% were female. 54. 6% of them were older than 60 years. 81. 87% of the patients produced sputum. Sputum bacteria culture, chest X-ray and chest CT were carried out to 21. 3% , 66. 3% and 11. 1% patients, respectively. 355 strains were isolated from patients whose sputum bacteria culture was positive. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella ca-tarrhalis were the three most isolates. 84. 7% of the 1583 AE-CB/COPD received 1692 times of antibiotic prescribing. The most frequently prescribed antibiotic were B-lactams (51. 36% of all antibiotic prescribing) , macrolides (14. 01%) and quinolones (31. 03% ). Much more macrolides were prescribed in the area where more patients pay the medicines at his own expense than those in the area where more patients share public health service. Conclusion In China, respiratory physicians can reasonably select antibiotics to manage acute exacerbation of chronic bronchitis/ chronic obstructive pulmonary disease in pulmonary outpatient department. Sputum culture is done in part of the patients, but susceptibility tests are missing. One issue revealed by the survey is that the list of prescribing medications laid down by government have great influence on antibiotic use.