Finch Roger G, Metlay Joshua P, Davey Peter G, Baker Lee J
Nottingham City Hospital and University of Nottingham, Nottingham, UK.
Lancet Infect Dis. 2004 Jan;4(1):44-53. doi: 10.1016/s1473-3099(03)00860-0.
National and international strategies for the control of antibiotic resistance recommend education for health-care professionals and the public to promote prudent antibiotic use. This paper, based on discussions at the 2002 colloquium of the International Forum on Antibiotic Resistance (IFAR), provides an international discourse between theoretical approaches to behaviour change and practical experience gained in large-scale antibiotic use educational campaigns. Interventions are more likely to be effective if their aim is to change behaviour, rather than provide information. They should target all relevant groups, especially parents, children, day-care staff, and health-care professionals. They should use clear and consistent messages concerning bacterial versus viral infection, prudent antibiotic use, symptomatic treatment, and infection-control measures (eg, handwashing). Campaigns should use a range of communications using pilot-testing, strong branding, and sociocultural adaptation. Prime-time television is likely to be the most effective public medium, while academic detailing is especially useful for health-care professionals. Multifaceted interventions can improve antibiotic prescribing to some degree. However, there are few data on their effects on resistance patterns and patient outcomes, and on their cost-effectiveness. Current research aims include the application of behaviour-change models, the development and validation of prudent antibiotic prescribing standards, and the refinement of tools to assess educational interventions.
控制抗生素耐药性的国家和国际战略建议对医疗保健专业人员和公众进行教育，以促进谨慎使用抗生素。本文基于2002年抗生素耐药性国际论坛（IFAR）研讨会的讨论，在行为改变的理论方法与大规模抗生素使用教育活动中获得的实践经验之间展开国际讨论。如果干预措施旨在改变行为而非提供信息，则更有可能有效。它们应针对所有相关群体，尤其是父母、儿童、日托工作人员和医疗保健专业人员。它们应就细菌感染与病毒感染、谨慎使用抗生素、对症治疗和感染控制措施（如洗手）传递清晰一致的信息。活动应采用一系列沟通方式，包括试点测试、强大的品牌塑造和社会文化适应。黄金时段的电视可能是最有效的公共媒介，而学术详述对医疗保健专业人员尤其有用。多方面的干预措施可以在一定程度上改善抗生素的处方。然而，关于它们对耐药模式和患者结局的影响以及成本效益的数据很少。当前的研究目标包括行为改变模型的应用、谨慎抗生素处方标准的制定和验证，以及评估教育干预措施工具的完善。
