Management of Acute Gastroenteritis in Children: A Survey among Members of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.
Abstract
Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.
참고문헌 (25)
- Guarino A, "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition", European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe : update 2014, 2014, pp.59, 132~152
- World Health Organization, "The treatment of diarrhoea: a manual for physicians and other senior health workers" (2005), World Health Organization
- Tieder JS, "Pediatric hospital adherence to the standard of care for acute gastroenteritis", Pediatrics, 124, pp.e1081~1087 (2009)
- Lo Vecchio A, "Adherence to guidelines for management of children hospitalized for acute diarrhea", Pediatr Infect Dis J, 33, pp.1103~1108 (2014)
- Spandorfer PR, "Oral versus intravenous rehydration of moderately dehydrated children : a randomized, controlled trial", Pediatrics, 115, pp.295~301 (2005)
- Nunez J, "Dehydration treatment practices among pediatrics-trained and non-pediatrics trained emergency physicians", Pediatr Emerg Care, 28, pp.322~328 (2012)
- 김아리, "Epidemiology and Factors Related to Clinical Severity of Acute Gastroenteritis in Hospitalized Children after the Introduction of Rotavirus Vaccination", Journal of Korean Medical Science, 32(3), pp.465~474 (2017), 대한의학회
- 강윤구, "한국 단일기관 응급실을 방문한 소아환자에서 급성위장염 발생과 지역 기온의 상관관계", 대한소아응급의학회지, 5(1), pp.19~24 (2018), 대한소아응급의학회[DOI]
- 김성윤, "일개 이차 병원에서 치료한 소아 급성 세균성 위장염 원인 및 특징", Pediatric Infection and Vaccine, 24(2), pp.95~101 (2017), 대한소아감염학회[DOI]
- Geurts D, "Implementation of clinical decision support in young children with acute gastroenteritis : a randomized controlled trial at the emergency department", Eur J Pediatr, 176, pp.173~181 (2017)
- Hartling L, "Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children", Cochrane Database Syst Rev, (3), pp.CD004390~ (2006)
- King CK, "Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy", MMWR Recomm Rep, 52(RR-16), pp.1~16 (2003)
- Assathiany R, "Treatment of acute gastroenteritis in private practice: a survey of 641 pediatricians", Arch Pediatr, 20, pp.1113~1119 (2013)
- Freedman SB, "Treatment of acute gastroenteritis in children : an overview of systematic reviews of interventions commonly used in developed countries", Evid Based Child Health, 8, pp.1123~1137 (2013)
- Ozuah PO, "Oral rehydration, emergency physicians, and practice parameters : a national survey", Pediatrics, 109, pp.259~261 (2002)
- Karpas A, "Parental preference for rehydration method for children in the emergency department", Pediatr Emerg Care, 25, pp.301~306 (2009)
- DeCamp LR, "Use of antiemetic agents in acute gastroenteritis : a systematic review and meta-analysis", Arch Pediatr Adolesc Med, 162, pp.858~865 (2008)
- Pfeil N, "Antiemetic medications in children with presumed infectious gastroenteritis--pharmacoepidemiology in Europe and Northern America", J Pediatr, 153, pp.659~662 (2008)
- Fedorowicz Z, "Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents", Cochrane Database Syst Rev, (9), pp.CD005506~ (2011)
- Rerksuppaphol S, "Randomized study of ondansetron versus domperidone in the treatment of children with acute gastroenteritis", J Clin Med Res, 5, pp.460~466 (2013)
- Freedman SB, "The treatment of pediatric gastroenteritis : a comparative analysis of pediatric emergency physicians' practice patterns", Acad Emerg Med, 18, pp.38~45 (2011)
- Guarino A, "Probiotics as prevention and treatment for diarrhea", Curr Opin Gastroenterol, 25, pp.18~23 (2009)
- Bruzzese E, "Hospital management of children with acute gastroenteritis", Curr Opin Gastroenterol, 29, pp.23~30 (2013)
- Carson RA, "Clinical practice guideline for the treatment of pediatric acute gastroenteritis in the outpatient setting", J Pediatr Health Care, 30, pp.610~616 (2016)
- Lo Vecchio A, "Comparison of recommendations in clinical practice guidelines for acute gastroenteritis in children", J Pediatr Gastroenterol Nutr, 63, pp.226~235 (2016)
