Holmes John H, Metlay Joshua, Holmes William C, Mikanatha Nkuchia
School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
AMIA Annu Symp Proc. 2003;2003:864.
The emergence of drug resistance among common community-acquired bacterial infections has been clearly linked to the overuse of antibiotics. To address this problem, guidelines have been developed for the judicious use of antibiotics, particularly with regard to respiratory infection in adults and children. In addition, the CDC has promulgated guidelines for the general public, exhorting patients not to take an antibiotic for viral illnesses, not to pressure practitioners for antibiotic therapy, not to use antibiotics prescribed for another person, and not to use antibiotics left over from a previous illness. Despite some overall decline in antibiotic use, patients continue to engage in antibiotic overuse practices, resulting in increasing antimicrobial resistance. One reasons for antibiotic overuse is "antibiotic expectation," in which patients expect to be treated with an antibiotic for an acute infection, whether it is viral or bacterial.1 This phenomenon points to an underlying system of beliefs held by patients toward antibiotic use that may be alterable by educational interventions.
常见社区获得性细菌感染中耐药性的出现已明确与抗生素的过度使用有关。为解决这一问题，已制定了明智使用抗生素的指南，尤其是针对成人和儿童的呼吸道感染。此外，美国疾病控制与预防中心（CDC）已为普通公众颁布了指南，劝诫患者不要因病毒疾病而服用抗生素，不要向医生施压要求进行抗生素治疗，不要使用为他人开的抗生素，也不要使用上次生病剩余的抗生素。尽管抗生素使用总体上有所下降，但患者仍继续存在抗生素过度使用的行为，导致抗菌药物耐药性不断增加。抗生素过度使用的一个原因是“抗生素期望”，即患者期望无论急性感染是由病毒还是细菌引起，都要用抗生素进行治疗。这种现象表明患者对使用抗生素存在一种潜在的信念体系，而这种信念体系可能会通过教育干预而改变。
