博碩士論文 etd-0709109-175128 詳細資訊


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姓名 歐善福(Shan-fu Ou) 電子郵件信箱 E-mail 資料不公開
畢業系所 高階經營碩士班(EMBA)
畢業學位 碩士(Master) 畢業時期 97學年第2學期
論文名稱(中) 兒童急性呼吸道感染在不同專科別的門診處方型態與用藥品質之探討
論文名稱(英) Discussing the Patterns and Quality of Prescriptions in Ambulatory Children with Acute Respiratory Tract Infection Among Different Specialists.
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    摘要(中) 自從全民健保開辦以來,呼吸道系統疾病一直都是醫療院所門診申報最常見的疾病,在申報前20大疾病中,急性呼吸道感染佔第一位,急性支氣管炎佔第三位,急性扁桃腺炎佔第十位,有見於國內對於不同專科別的兒童急性呼吸道感染其門診處方型態與用藥品質的研究闕如,本研究設計為一回溯性橫斷面研究,針對0-14歲急性呼吸道感染兒童在國軍左營總醫院小兒科、家醫科和耳鼻喉科三個不同專科別進行其門診處方型態與用藥品質之描述性與推論性分析,以作為提升小兒用藥品質與用藥安全的參考。
      本研究共分析788個就診人次,其中小兒科270人次,家醫科261人次,耳鼻喉科257人次,一、處方型態:在診斷方面,三個專科的上呼吸道感染都比下呼吸道感染多,其中都以急性鼻咽炎或感冒最常見,其次為急性支氣管炎,前三位的診斷已包含三個科別八成以上的診斷。在用藥筆數方面,以耳鼻喉科每就醫人次處方4.20筆最高,家醫科2.77筆最低。在藥理分類方面,三個科別都是以咳嗽及感冒製劑最常見(大於80%),其次是抗組織胺(大於60%),抗氣喘藥劑的被處方以小兒科最高(40.4%)、耳鼻喉科最低(1.9%),解熱鎮痛劑的被處方以耳鼻喉最高(60.3%)、小兒科最低(28.9%),抗生素的被處方以耳鼻喉科最高(28.8%),家醫科最低(5.7%),在抗氣喘藥、解熱鎮痛劑和抗生素的使用上,三個科別存在顯著性差異。二、用藥品質:小於六歲兒童被處方小兒專用藥劑的比例以家醫科最高(65.8%)、耳鼻喉科最低(46.2%),藥物磨粉部份以耳鼻喉科最高(51.3%)、家醫科最低(34.2%)。在並用相同藥理分類藥物方面,小兒科、家醫科和耳鼻喉科的比例分別為23%、13.4%及19.8%,其中以咳嗽及感冒製劑最常被並用。在不適當處方方面,三個科別的比例分別為小兒科7.4%、家醫科11.5%及耳鼻喉科10.9%,其中以非核准範疇內使用,如年齡、適應症和劑量不符最常見,各科藥物不良反應的比例分別為小兒科1.5%、家醫科1.1%及耳鼻喉科2.3%
      本篇研究結果顯示,不同科別針對兒童急性呼吸道感染的處方型態與用藥品質差異頗大,各科仍然有相當比例的抗生素被處方在感冒、其他非特異性上呼吸道感染和支氣管炎病患身上,如何減少不適當處方、藥物不良反應和加強各專科醫師對於小兒用藥安全的知識,實是當務之急。
    摘要(英) Respiratory system disorders are always the most frequently diseases in the ambulatory claim of the hospitals since the implementation of National Health Insurance. Of the top twenty diagnoses, acute respiratory tract infections are the most common diagnoses, third as acute bronchitis, and tenth as acute tonsillitis. Due to the shortage of studies in discussing the prescribing patterns and quality of prescriptions in ambulatory children with acute respiratory tract infections among different specialists in our country, this study is a retrospective cross-section design. All the children who were below 14 years of age , diagnosed to be acute respiratory tract infection and have visited in the pediatric, family medicine, or otolaryngological departments were enrolled in this study. Descriptive and inferential analysis were performed in order to analyze the patterns and quality of prescriptions among different specialists. The result of research may be a useful and important reference for promotion of prescribing quality and medication safety.
      There were 788 ambulatory visits recorded in this study. They consisted of 270 pediatric visits, 261 family medicine visits, and 257 otolaryngological visits. The results were devided into two categories:
    1. Prescribing patterns: (1) In terms of principal diagnosis, upper respiratory tract infections were more common than lower respiratory tract infections in the three specialists. The majority of diagnoses were acute nasopharyngitis or common cold, followed by acute bronchitis. The top three diseases occupied more than 80% of all diagnoses. (2) In terms of medications prescribed, the highest medications prescribed was 4.20 drugs by the otolaryngological physicians, while the lowest was 2.77 drugs by the family medicine physicians. (3) In terms of pharmacologic classification, the most commonly prescribed medication was cough and cold preparations with more than 80% of prescribing rate in the three specialists, followed by antihistamines with more than 60% of prescribing rate. The highest prescribing rate of anti-asthmatic agents was 40.4% by the pediatricians, while the lowest rate was 1.9% by the otolaryngological physicians. The highest prescribing rate of antipyretic & antalgic agents was 60.3% by the otolaryngological physicians, while the lowest rate was 28.9% by the pediatricians. The highest prescribing rate of antibiotics was 28.8% by the otolaryngological physicians, while the lowest rate was 5.7% by the family medicine physicians. There was significant difference between the prescribing rate about anti-asthmatic, antipyretic & antalgic agents , and antibiotics and different specialists .
    2. Quality of prescriptions: (1) In terms of children-specific preparations for less than 6 years of age, the highest prescribing rate was 65.8% by the family medicine physicians, while the lowest rate was 46.2% by the otolaryngological physicians. On the contrary, the highest prescribing rate of powdered medications was 51.3% by the otolaryngological physicians, and the lowest rate was 34.2% by the family medicine physicians. (2) In terms of concurrent use of drug classification, the prescribing rate by the pediatricians, family medicine physicians and otolaryngological physicians was 23%, 13.4% and 19.8%, respectively. Cough and cold preparations were the most commonly prescribed agents.(3) In terms of inappropriate medication use, there was 7.4%, 11.5% and 10.9%, respectively corresponding to the three specialists.Off-label drugs were the most common causes for inappropriate medication use. (4) In terms of adverse drug response or side effects, there was 1.5%, 1.1% and 2.3%, respectively corresponding to the three specialists.
      According to the results, significant difference existed among different specialists in terms of prescribing patterns and quality of prescriptions in ambulatory children with acute respiratory tract infections. A substantial proportions of antibiotics were still prescribed to children diagnosed as having common cold, nonspecific upper respiratory tract infection, and bronchitis. It is important to educate the medication safety of children to different specialists and to reduce the prescribing rate of inappropriate medication use and adverse drug response.
    關鍵字(中)
  • 處方型態
  • 用藥品質
  • 呼吸道感染
  • 門診
  • 兒童
  • 關鍵字(英)
  • none
  • 論文目次 論文提要 …………………………………………………i
    中文摘要………………………………………………………….ii
    英文摘要………………….……………………………..v
    誌謝詞……………………………………………………vii
    目錄………………………………………………………..ix
    表目錄……………………………………………………..xi
    圖目錄………………………………………………………….xii
    第一章 緒論………...……………………………………..1
    第一節 研究背景與動機………………………………...1
      第二節 研究目的……………………………………....2
    第二章 文獻探討……………………………………........3
      第一節 小兒呼吸道感染……………………………....3
      第二節 小兒處方型態……………………………….10
      第三節 小兒用藥安全……………………………….16
      第四節 小兒呼吸道疾病的藥物交互作用………….23
      第五節 小兒呼吸道感染抗生素的使用……………27
      第六節 專科別在照護上的差異................................35
    第三章 研究設計與研究方法…………........…………38
      第一節 研究範圍........................................................38
      第二節 研究流程........................................................38
      第三節 研究架構………....…………………………41
      第四節 變項的說明…………………………………41
      第五節 資料分析……………………………………44
    第四章 研究結果分析與探討…………………………46
      第一節 處方型態的描述性統計分析………………46
      第二節 用藥品質的描述性統計分析………………50
      第三節 推論性統計分析……………………............52
    第五章 結論與建議……………………………………60
      第一節 結論…………………………………………60
      第二節 建議…………………………………………62
      第三節 研究限制……………………………………63
    參考文獻……………………………………………....64
      一、中文部份……………………………………....64
      二、英文部份……………………………………....66
      三、網頁部份……………………………………...73
    附錄一 兒童專用藥劑使用情形問卷調查…...……...74
    附錄二102種兒童專用藥劑品項表…………....……79
    附錄三 ATC藥品分類系統於健保局給付藥品的應用..85
    參考文獻 (一)中文部份
    王凌峰,2006,「急性咽喉炎」,高醫醫訊,26卷7期:7。
    中央健康保險局,2001年2月,「全民健康保險藥品給附規定」,台北市:中央健康保險局。
    何雨桐、張意宜、李立達,2008,「藥品磨粉分包之品質與認知調查研究」,醫院醫學,25卷3-4期:102∼110。
    吳惠美、施李碧玉,2003,「藥物交互作用之發生率及發生機轉」,北市醫學雜誌,1卷3期:372∼379。
    呂友敏,1998,全民健保小兒處方型態及用藥品質之分析,國立成功大學臨床藥學研究所碩士論文。
    李敏生,2006,「小兒上呼吸道感染 ─ 與成人大不同」,高醫醫訊,26卷7期:10。
    李錫裕,2002,實用臨床藥品交互作用,台灣省政府衛生處印製。
    林攸美,2002,磨粉分包作業之品質及小兒用藥指導之成效探討。台北醫學大學藥學研究所碩士論文。
    林孟穎,2007,「一般常見的藥物交互作用」,嘉基藥訊,69期 4∼8。
    林嬪嬙,2008,「兒童專用藥劑 寶寶健康更有保障」,嬰兒與母親,384期:220∼222。
    洪仁宇,2006,「10大就診原因之一 ─ 急性支氣管炎」,高醫醫訊,26卷7期:12。
    洪碧蓮、林佩津、曾碧萊,2007,「小兒及新生兒加護病房處方藥物不適當性之調查」,台灣臨床藥學雜誌,14卷4期:1∼19。
    財團法人台灣醫療改革基金會,2007。兒童吃藥冒大險,正視兒童藥劑的重要性。 醫改會訊18期。
    財團法人台灣醫療改革基金會,2007。醫改會調查:至少102種健保兒童專用藥。   醫改雙月刊22期。
    財團法人台灣醫療改革基金會,2008,「健保兒童專用藥至少102種」,嬰兒與母親,375 期:82∼87。
    高雅惠,1998,全民健保門診用藥型態之分析研究,行政院衛生署委託研究計劃。
    高雅慧,2001,以ATC分類探討全民健保藥品之利用與分配,國立成功大學臨床藥學研究所受行政院衛生署委託研究計畫。
    張上淳、陳淑姬、龐一鳴等,2004,「台灣上呼吸道感染抗生素使用之調查分析」,感染控制雜誌,14卷3期:133∼ 139。
    張上淳、楊采菱、蘇益仁,2007,「台灣抗生素使用及細菌抗藥性現況及政策推行共識」,感染控制雜誌,17卷1期:57∼59。
    張克昌,2003,「鼻竇炎的診斷及治療」,台北市醫師公會會刊,47卷12期:75∼79。
    張豫立、周美惠,1996,「藥物交互作用」,臨床藥學,38卷6期:403∼410。
    莊美華、林俊龍,2003,「醫療機構用藥疏失之探討」,慈濟醫學,15卷4期:247∼258。
    許育彰、黃文鴻、鄭守夏,2003,「門診非成癮性止痛藥之處方型態」,台灣醫學,7卷6期:850∼859。
    許清曉,2005,「抗生素的使用如何管制?」感染控制,15卷2期:81∼87。
    連婉君,2004,上呼吸道疾病的藥物交互作用,國立政治大學統計研究所碩士論文。
    陳奕帆、陳妙文,2007,「特殊族群病患之用藥安全監控」,慈濟醫學,19卷增刊1期:55∼60。
    陳招式,2002,門診急性呼吸道感染及氣喘病患醫療資源耗用分析,高雄醫學大學健康科學院公共衛生研究所碩士論文。
    陳彥旭,2006,「呼吸道感染面面觀」,高醫醫訊,26卷7期:4。
    彭子安,2005,「用藥安全─淺談兒科用藥疏失」,耕莘藥訊,21期:1∼2。
    黃亮迪,2005,「兒科診療室─小兒安全用藥指南」,嬰兒與母親,343期:170∼176。
    黃煜琁、黃玉成,2005,「台灣兒童上呼吸道感染之抗生素使用建議」,長庚醫誌,28卷11期:758∼764。
    黃肇明,1999,全民健保藥品給付政策,國立成功大學臨床藥學研究所藥事行政演講,台南。
    鄭師安,2004,「鼓勵發展兒童用藥 歐盟修改相關醫藥法規」,生技與醫療器材報導66期。
    戴任恭,2006,「小生怕怕 ─ 從兒童成長談下呼吸道感染之細支氣管炎與肺炎」,高醫醫訊,26卷7期:11。
    戴志峰,1998,「談小兒鼻竇炎」,高醫醫訊,18卷5期:16。
    戴慧玲、蔡孟憲,2007,「某地區醫院內科及耳鼻喉科醫師治療上呼吸道感染之開立抗生素習慣比較」,感染控制雜誌,17卷5期:299∼306。
    臨床兒科學,第六版,2001,馬偕紀念醫院小兒科,嘉洲出版社,台北:287∼323頁。
    謝慧貞,2003,「認識藥物交互作用」,臨床藥學,19卷1期:102∼108。
    (二)英文部份
    Anonymous unapproved uses of approved drugs: the physician, the package insert,1996, Pediatrics 98: 143-145.
    Baksas I.,& Lunde P. 1984. Pattern of European diagnosis and prescribing. Pharmacy International 3:187-188.
    Behrman, R.E., Kliegman, R.M.,& Jenson, H.B. 2000. Nelson textbook of pediatrics. 16ed, Philadelphia, WB Saunders.
    Bluestone, C.D.,& Klein, J.O. 2001. Otitis media in infants and children, 3rd. Philadelphia, WB Saunders.
    Blumer, J. 1998.Clinical perspectives on sinusitis and otitis media. Pediatr Infect Dis J 17: s68-72.
    Brook, I., Gooch, W.M. ,& Jenkins, S.G. et al. 2000. Medical management of acute bacterial sinusitis: Recommendations of a clinical advisory committee on pediatric and adult sinusitis. Ann Otol Rhinol Laryngol 109:2-20.
    Cappelletty, D. 1998. Microbiology of bacterial respiratory infections. Pediatr Infect Dis J 17: S55-61.
    Chang, S.C. , Chang, H.J.,& La, M.S. 1999. Antibiotic usage in primary care units in Taiwan. Int J Antimicrob Agents 11:23-30.
    Chang, S.C. , Shiu, M.N. ,& Chen, T.J. 2001. Antibiotic usage in primary care units in Taiwan after the institution of national health insurance. Diagn Microbiol Infect Dis 40: 137-143.
    Chang, S.C., Hsieh, W.C. ,& Liu, C.Y. 2000. The Antibiotic Resistance Study Group of the infectious Disease Society of the Republic of China:High prevalence of antibiotic resistance of common pathogenic bacteria in Taiwan. Diagn Microbiol Infect Dis 36:107-112.
    Cloutier, M.M. ,& Loughlin, G.M. 1981. Chronic cough in children: a manifestation of airway hyperreactivity. Pediatrics 67: 6-12.
    Conroy, S. , Choonara, I. ,& Impicciatore, P. 2000. Survey of unlicensed and off label drug use in paediatric wards in European countries. European Network for Drug Inventigation in ChildrenL BMJ. 320(7227):79-82.
    Conroy, S. 2008. Child-friendly preparations in hospitals. FIP”Making paediatric medicines work”section. Basel.
    Cote, C.J., Kauffman, R.E. ,& Troendle, G.J. 1996. Is the "therapeutic orphan" about to be adopted? Pediatrics; 98: 118-23.
    Cuzzolin, L. , Atzei, A. ,& Fanos, V. 2006. Off-label and unlicensed prescribing for newborns and children in different settings: a review of the literature and a consideration about drug safety. Expert Opin Drug Saf 5(5):703-718.
    Davy, T., Dick, P.T.,& Munk, P. 1998. Self-reported prescribing of antibiotics for children with undifferentiated acute respiratory tract infections with cough. Pediatr Infect Dis J 17: 457-462.
    Dowel, S.F., Schwartz, B. ,& Phillips, W.R. 1998d. Appropriate use of antibiotics for URIs in children: Part II. Cough, pharyngitis and the common cold. Am Fam Physician 58: 1335-1342.
    Dowell, S.F., Marcy, S.M. ,& Phillips, W.R. et al.1998a. Otitis media----Principles of judicious use of antimicrobial agents. Pediatrics 101: 165-171.
    Dowell, S.F., Marcy, S.M. ,& Willam, R. et al.1998b. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics 101: 163-165.
    Dowell, S.F., Schwartz, B. , & Phillips, W.R. 1998c. Appropriate use of antibiotics for URIs in children: Part I. Otitis media and acute sinusitis. Am Fam Physician 58: 1113-1118.
    Falck, G., Gnarpe, J.,& Gnarpe, H. 1997. Prevalence of Chlamydia pneumoniae in healthy children and in children with respiratory tract infections. Pediatr Infect Dis J 16: 549-554.
    Foy, H.M.1993. Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis 17: S37- 46.
    Fujita, K., Murono, K.,& Yoshikawa, M. et al. 1994. Decline of erythromycin resistance of group A streptococci in Japan. Pediatr Infect Dis J 13: 1075-1078.
    Gadomski, A.M. 1993. Potential interventions for preventing pneumonia among young children: lack of effect of antibiotic treatment for upper respiratory infections. Pediatr Infect Dis J 12:115-120.
    Garibaldi, R.A.1985.Epidemiology of community-acquired respiratory tract infections in adults. Incidence, etiology and impact. Am J Med 78: 32-37.
    Gilbert, D.N., Moellering, R.C.,& Sande, M.A. 1998. Guide to antimicrobial therapy.
    Guideline for antimicrobial therapy of acute upper respiratory tract infections in Taiwan. 2002.J Microbiol Immunol Infect 35: 272 - 273.
    Guillemot, D., Carbon, C., &Vauzelle-Kervroedan, F.,et al.1998. Inappropriateness and variability of antibiotic prescription among French office-based physicians. J Clin Epidemiol 51: 61-68.
    Gwaltney, J.M. 1996. Acute community-acquired sinusitis. Clin Infect Dis 23: 1209-1223.
    Gwaltney, J.M.:The common cold. In: Mandell, G.L., Bennett, J.E., & Dolin, R. eds. 2005. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier, Churchill Livingstone.
    Hays, G. C.,& Mullard, J. E.1972. Can nasal bacterial flora be predicted from clinical findings? Pediatrics 49: 596-599.
    Hendrickse, W.A., Kusmiesz. H., & Shelton, S. 1988. Five vs. ten days of therapy for acute otitis media. Pediatr Infect Dis J 7: 14 - 23.
    Hill, S. 2008.The WHO essential medicines list for children. 2008 FIP”Making paediatric medicines work” section. Basel.
    Ho, M. , Mcdonald, L.C., & Lauderdale, T.L. et al. 1999. Surveillance of antibiotic resistance in Taiwan,1998. J Microbiol Immunol Infect 32: 239 - 249.
    Hoberman, A., Paradise, J.L., & Burch, D.J. 1997. Equivalent efficacy and reduced occurrence of diarrhea from a new formulation of amoxicillin/clavulanate potassium (Augmentin) for treatment of acute otitis media in children. Pediatr Infect Dis J 16: 463- 470.
    Hui, L., Li, X.S., & Zeng, X.J. 1997. Patterns and determinants of use of antibiotics for acute respiratory tract infection in children in China. Pediatr Infect Dis J 16: 560-564.
    Ingvarsson, L.,& Lundgren, K. 1982. Penicillin treatment of acute otitis media in children. A study of the duration of treatment. Acta Oto Laryngologica 94: 283-287.
    Kaushal, R., Bates, D.W., & Landrigan C, et al. 2001. Medication Errors and Adverse Drug Events in Pediatric Inpatients. JAMA 285 : 2114-2120.
    Kaverner, K.J., Nafstad, P.,& Jaakkola, J.J.2000. Upper respiratory morbidity in preschool children: a cross-sectionl study. Arch Otol-head & Neck Surgery 126:1201-1206.
    Kim, M.R., Lee, H.R., & Lee, G.M.2000. Epidermiology of acute viral respiratory tract infections in Koean children. J of infection 41:152-158.
    Klein, J.O., & Mccracken, G.H. 1999. Management of otitis media. Pediatr Infect Dis J 18: 1119-1155.
    Levin, R.H. 1996. Pediatric and neonatal therapy Textbook of therapeutics: Drug and disease managemen 88 : 1687- 1692.
    Malcolm Rowland, P. D., Thomas, N.T., PhD. 1995. Age and weight. In: Magee, R. D. Clinical pharmacokinetics: concepts and applications, 15: pp. 230-247.
    Macdonald, W.B.G., & Geelhoed, G.C. 1997. Management of childhood croup. Thorax 52: 757- 759.
    Mainous, A.G., Hueston, W.J., & Love, M.M. 1998. Antibiotics for colds in children: who are the high prescribers? Arch Pediatr Adolesc Med 152: 349-352.
    Mainous, A.G., Hueston, W.J. & Love, M.M. 1998. Antibiotics for colds in children: who are the high prescribers? Arch Pediatr Adolesc Med 152:349-352.
    McCaig, L.F., & Hughes, J.M. 1995. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA 273: 214- 219.
    McKinzie, J.P., Wright, S.W., & Wrenn, K.D. 1997. Pediatric drug therapy in the emergency department: does it meet FDA-approved prescribing guidelines? Am J of Emerg Med 15: 118-121.
    Nyquist, A.C., Gonzales, R., & Steiner, J.F. 1998. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA 279: 875-877.
    O'Brien, K.L., Dowell, S.F., & Schwartz, B. 1998a. Acute sinusitis--Principles of judicious use of antimicrobial agents. Pediatrics 101: 174-177.
    O'Brien, K.L., Dowell, S.F., & Schwartz, B. 1998b. Cough illness/bronchitis----Principles of judicious use of antimicrobial agents. Pediatrics 101: 178-181.
    Pandolfini, C., & Bonati, M. 2005. A literature review on off-label drug use in children. Eur J Pediatr 164 (9):552-558.
    Paradise, J. L.1995. Managing otitis media: a time for change. Pediatrics 96: 712-715.
    Pichichero, M.E., & Cohen, R. 1997. Shortened course of antibiotic therapy for acute otitis media, sinusitis and tonsillopharyngitis. Pediatr Infect Dis J 16: 680-695.
    Putto, A. 1987. Febrile exudative tonsillitis: viral or streptococcal? Pediatrics 80: 6-12.
    Rokstad, K., Straand, J.,& Fugelli, P. 1997.General practitioners' drug prescribing practice and diagnoses for prescribing: the More & Romsdal Prescription Study. J of Clin Epidemiol 50: 485-94.
    Rosenstein, N., Phillips, W.R., & Gerber, M.A. 1998. The common cold-- Principles of judicious use of antimicrobial agents. Pediatrics 101: 181-184.
    Sam, T. 2008. Pharmacertical development of medicines for paediatric use. FIP”Making paediatric medicines work”section. Basel.
    Sanz, E. J., Bergman, U., & Dahlstrom, M.1989. Paediatric drug prescribing. A comparison of Tenerife (Canary Islands, Spain) and Sweden. Eur J Clin Pharmacol 37: 65-8.
    Schirm, E., &Tobi, H. 2003. Risk factors for unlicensed and off-label drug use in children outside the hospital. Pediatrics 111(2):291-295.
    Schwatrz, B., Marcy, S.M.,& Phillips, W.R. 1998. Pharyngitis----Principles of judicious use of antimicrobial agents. Pediatrics 101: 171- 174.
    Seppala, H., Klaukka, T., & Vuopio-Varkila, J., et al. 1997. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. N Engl J Med 337: 441- 446.
    Shulman, S.T., Gerber, M.A., & Tanz, R.R., et al. 1994. Streptococcal pharyngitis: the case for penicillin therapy. Pediatr Infect Dis J 13: 1-7.
    Standiford, H. C. 1995.Tetracyclines and chloramphenicol. Principles and practice of infectious diseases, 21: pp. 306-317.
    Straand, J., Rokstad, K. ,& Heggedal, U. 1998. Drug prescribing for children in general practice. A report from the More & Romsdal Prescription Study. Acta Paediatr 87: 218-224.
    Todd, J.K. 1984. Bacteriology and clinical relevance of nasopharyngeal and oropharyngeal cultures. Pediatr Infect Dis J 3: 159-163.
    Turner, S., Nunn, A.J., & Fielding, K., et al. 1999. Adverse drug reactions to unlicensed and off-label drugs on paediatric wards: a prospective study. Acta Paediatr 88(9):965-8.
    Ufer, M., Kimland, E., & Bergman, U. 2004. Adverse drug reactions and off-label prescribing for paediatric outpatients: a one-year survey of spontaneous reports in Sweden. Pharmacoepidemiol Drug Saf 13(3):147- 52.
    Wald, E.R., Guerra, N.,& Byers, C. 1991. Upper respiratory tract infections in young children: duration of and frequency of complications. Pediatrics 87: 129- 133.
    Weissenbacher, M., Carballal, G., & Avila, M., et al.1990. Etiologic and clinical evaluation of acute lower respiratory tract infections in young Argentinian children: an overview. Rev of Infect Dis 12: S889-898.
    WHO Collaborating Centre for drug Statistics Methodology. 1996. WHO Anatomical Therapeutic Chemical classification index.
    WHO Collaborating Centre for Drug Statistics Methodology.1996.WHO Guidelines for ATC classification and DDD assignment. 
    (三) 網頁部分
    中央健康保險局,2001;2005;2006,http://www.nhi.gov.tw/。
    行政院衛生署消費者資訊網,2007,「重視小兒用藥安全問題,守護您家的小寶貝」,http:// drug.doh.gov.tw/。
    行政院衛生署藥品交互作用資料庫系統,2009,http://dif.doh.gov.tw/。
    財團法人台灣醫療改革基金會,2007;2008,http://www.thrf.org.tw/。
    財團法人醫院評鑑暨醫療品質策進會,2007,http://www.tjcha.org.tw/。
    國軍桃園總醫院藥品資訊查詢公布欄,2008,「兒童用藥安全
    口試委員
  • 陳世哲博士 - 召集委員
  • 李英俊博士 - 委員
  • 葉淑娟 博士 - 指導教授
  • 口試日期 2009-06-12 繳交日期 2009-07-09

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