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동물교상으로 응급실을 방문한 소아환자의 광견병 노출 후 예방의 적절성

Appropriateness of rabies post-exposure prophylaxis in pediatric patients visiting the emergency department due to animal bite

대한소아응급의학회지 2020년 7권 1호 p.23 ~ 27
유제준, 고정인, 여운형, 박태진, 정성구, 권재현,
소속 상세정보
유제준 ( Yoo Jhe-Jun ) - National Medical Center Department of Emergency Medicine
고정인 ( Ko Jung-In ) - National Medical Center Department of Emergency Medicine
여운형 ( Yeo Woon-Hyung ) - National Medical Center Department of Emergency Medicine
박태진 ( Park Tae-Jin ) - National Medical Center Department of Emergency Medicine
정성구 ( Jung Sung-Koo ) - National Medical Center Department of Emergency Medicine
권재현 ( Kwon Jae-Hyun ) - CHA University CHA Bundang Medical Center Department of Emergency Medicine

Abstract


Purpose: To study the appropriateness of rabies post-exposure prophylaxis (rPEP) for children with animal bite who visited the emergency department (ED).

Methods: The study enrolled children younger than 18 years with animal bite who visited the National Medical Center ED between January 2014 and October 2017. The children’s electronic medical records were retrospectively reviewed. Data for analysis included age, sex, body parts bitten by animals, species of animals, regions where animal bites occurred, history of recent antibiotics therapy and tetanus vaccination, and justification by the 2017 Guidelines for Rabies Control in Korea and implementation of rPEP. In children who underwent unjustified rPEP or did not undergo justified one, we recorded their guardians’ opinion for or against rPEP.

Results: Of the 63 enrolled children, rPEP was justified for 38 children by the Korean guidelines. Of the 38 children, 35 actually underwent rPEP. Among the remaining 3 children, 2 did not undergo the prophylaxis as per the guardians’ requests. Among the 25 children whose rPEP was not justified, 8 underwent the prophylaxis. Of these 8 children, 7 did based on the guardians’ requests.

Conclusion: In this study, inappropriate rPEP was usually affected by the guardians’ requests, regardless of the criteria for such prophylaxis. Thus, their requests for or against rPEP should be discussed with emergency physicians who are aware of the relevant criteria to prevent occurrence of rabies or unnecessary use of medical resources.

키워드

Emergency Medicine; Pediatrics; Post-Exposure Prophylaxis; Rabies; Rabies Vaccine

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