Schwartz B
Respiratory Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1999 Feb;28(2):211-3. doi: 10.1086/515115.
The spread of antimicrobial resistance is an important emerging health threat in developed countries. Widespread outpatient antimicrobial use leads to the spread of resistance among community-acquired pathogens such as Streptococcus pneumoniae. The Centers for Disease Control and Prevention and partner organizations have initiated a national campaign promoting more judicious antimicrobial use to decrease the spread of resistance. The initial focus is to improve management of respiratory tract infections, which account for most outpatient antimicrobial use. Survey and focus group results indicate that patient pressure and suboptimal diagnosis and treatment contribute to antibiotic overuse. To educate physicians, a series of "principles of judicious antibiotic use" have been developed that identify optimal approaches to management of common respiratory infections. Patient education materials and strategies to improve doctor-patient communication also have been developed. Several studies currently under way will evaluate the impact of intervention on antibiotic use practices and resistant carriage or infection.
在发达国家，抗菌药物耐药性的传播是一个重要的新出现的健康威胁。门诊广泛使用抗菌药物导致社区获得性病原体（如肺炎链球菌）之间耐药性的传播。疾病控制和预防中心及合作组织已发起一项全国性运动，倡导更合理地使用抗菌药物，以减少耐药性的传播。最初的重点是改善呼吸道感染的管理，呼吸道感染占门诊抗菌药物使用的大部分。调查和焦点小组结果表明，患者压力以及诊断和治疗欠佳导致了抗生素的过度使用。为了教育医生，已制定了一系列“合理使用抗生素原则”，确定了常见呼吸道感染管理的最佳方法。还制定了患者教育材料和改善医患沟通的策略。目前正在进行的几项研究将评估干预措施对抗生素使用习惯以及耐药菌携带或感染的影响。
