Podolsky Scott H
Massachusetts General Hospital, Department of Social Medicine, Harvard Medical School, Boston, MA 02114, USA.
Am J Public Health. 2005 Dec;95(12):2144-54. doi: 10.2105/AJPH.2004.048397. Epub 2005 Oct 27.
For a brief period from the 1930s through the early 1940s, public health advocates made pneumonia a leading public health concern. Predicated on the need for antipneumococcal antiserum, but also incorporating physician reeducation, state "pneumonia control programs" were established nationwide. However, with the advent of penicillin and the sulfonamides, the pneumonia control programs soon collapsed. Pneumonia reverted to the domain of the private practitioner, which was devoid of state oversight. With the emergence of pneumococcal antibiotic resistance in the 1990s, the possibility again arose that pneumonia could become a public health concern, given the nationwide need to curb unnecessary antibiotic usage and to encourage vaccination. An understanding of the history of pneumonia's changing status could shed light on current attempts to reformulate the disease and elucidate the contested domains of private practice and public health.
从20世纪30年代到40年代初的一段短暂时期内，公共卫生倡导者将肺炎列为主要的公共卫生问题。基于对抗肺炎球菌抗血清的需求，并结合医生再教育，全国范围内建立了州“肺炎控制项目”。然而，随着青霉素和磺胺类药物的出现，肺炎控制项目很快瓦解。肺炎又回到了私人执业医生的领域，而这一领域缺乏国家监管。随着20世纪90年代肺炎球菌抗生素耐药性的出现，鉴于全国范围内需要遏制不必要的抗生素使用并鼓励接种疫苗，肺炎再次有可能成为公共卫生问题。了解肺炎地位变化的历史，有助于阐明当前对该疾病重新规划的尝试，并厘清私人执业和公共卫生存在争议的领域。
