Grigoryan Larissa, Burgerhof Johannes G M, Haaijer-Ruskamp Flora M, Degener John E, Deschepper Reginald, Monnet Dominique L, Di Matteo Antonella, Scicluna Elizabeth A, Bara Ana-Claudia, Lundborg Cecilia Stålsby, Birkin Joan
Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
J Antimicrob Chemother. 2007 Jan;59(1):152-6. doi: 10.1093/jac/dkl457. Epub 2006 Nov 22.
Self-medication with antibiotics may increase the risk of inappropriate use and the selection of resistant bacteria. One of the triggers for using self-medication may be past experience with antibiotics prescribed by health professionals. We examined the association between prescribed use and self-medication with antibiotics.
A population survey was conducted in 19 European countries, covering 15,548 respondents. Multinomial logistic regression analysis was used to study the relationship between prescribed use and self-medication for all symptoms/diseases and for upper respiratory tract infections (URTIs).
The association between prescribed use and self-medication was modified by source of self-medication, region in Europe and education. This association was consistently stronger for self-medication from leftovers than from other sources, primarily directly from a pharmacy. It was stronger also for respondents from Northern/Western Europe than respondents from Eastern Europe and Southern Europe and those with low education. Prescribed use for URTIs (minor ailments such as throat symptom, influenza, etc.) increased the likelihood of self-medication with leftover antibiotics for these symptoms/diseases in all European regions.
Our study shows consistent associations between prescribed use and self-medication with antibiotics from leftovers, but has not been able to support the hypothesis that self-medication from other sources than leftovers is triggered by earlier prescribed use. Preventing leftovers may be one effective way of preventing self-medication. This can be achieved by ensuring that the amount dispensed corresponds to the amount prescribed, by educating patients and by making doctors aware that prescribing for minor ailments may increase the risk of self-medication for such ailments.
自行服用抗生素可能会增加用药不当以及选择耐药菌的风险。自行用药的触发因素之一可能是过去接受医疗专业人员开具抗生素的经历。我们研究了抗生素的处方使用与自行用药之间的关联。
在19个欧洲国家开展了一项人口调查，涵盖15548名受访者。采用多项逻辑回归分析来研究所有症状/疾病以及上呼吸道感染（URTIs）的处方使用与自行用药之间的关系。
处方使用与自行用药之间的关联因自行用药的来源、欧洲地区和教育程度而有所不同。与其他来源相比，尤其是直接从药店获取药物，服用剩余药物进行自行用药的这种关联始终更强。北欧/西欧的受访者比东欧和南欧的受访者以及受教育程度低的受访者的这种关联更强。上呼吸道感染（如喉咙症状、流感等轻症）的处方用药增加了在所有欧洲地区使用剩余抗生素自行治疗这些症状/疾病的可能性。
我们的研究表明，处方使用与服用剩余抗生素自行用药之间存在一致的关联，但未能支持以下假设，即除剩余药物外其他来源的自行用药是由先前的处方用药引发的。防止药物剩余可能是预防自行用药的一种有效方法。这可以通过确保配药量与处方量相符、对患者进行教育以及让医生意识到为轻症开处方可能会增加此类轻症自行用药的风险来实现。
