Wise Richard
City Hospital, Birmingham, UK.
J Antimicrob Chemother. 2004 Aug;54(2):306-10. doi: 10.1093/jac/dkh340. Epub 2004 Jul 1.
Antibiotics have undoubtedly made a major contribution to improvements in both human and animal health and welfare. Recent years have brought alarming rises in the prevalence of resistance to some agents among certain groups of bacteria. Concern is growing that therapeutic options will become increasingly limited if resistance rates continue to rise. There is widespread agreement that action is required to reverse or at least slow this process. Necessary steps to manage the situation include better surveillance to assess accurately the extent of problems, more prudent use of the available antibiotics to conserve valuable therapeutic resources and improved infection control to limit the spread of resistant organisms. Achieving these goals will not be possible without government, the medical profession and the public being better informed and educated. Regulatory bodies and the pharmaceutical industry need to work together to ensure a steady supply of new antimicrobials. Our understanding of the processes driving resistance at both the molecular and population levels is advancing. However, the relative contributions of the various uses of antimicrobials to the resistance problem and which will be the most effective containment measures are still hotly debated. Progress is being made, but continued concerted action is necessary if the usefulness of this most important group of therapeutic agents is to be preserved.
抗生素无疑对人类和动物的健康与福祉改善做出了重大贡献。近年来,某些细菌群体对一些药物的耐药性患病率惊人地上升。人们越来越担心,如果耐药率继续上升,治疗选择将越来越有限。人们普遍认为需要采取行动来扭转或至少减缓这一进程。应对这种情况的必要措施包括加强监测以准确评估问题的严重程度,更谨慎地使用现有抗生素以保护宝贵的治疗资源,以及加强感染控制以限制耐药菌的传播。如果政府、医疗行业和公众没有得到更好的信息和教育,就不可能实现这些目标。监管机构和制药行业需要共同努力,确保新抗菌药物的稳定供应。我们对在分子和群体水平上推动耐药性的过程的理解正在不断进步。然而,抗菌药物的各种用途对耐药性问题的相对贡献以及哪些将是最有效的遏制措施仍存在激烈争论。正在取得进展,但要保留这一最重要治疗药物组的效用,仍需要持续的协同行动。