McNulty Cliodna A M, Boyle Paul, Nichols Tom, Clappison Peter, Davey Peter
Health Protection Agency Primary Care Unit, Microbiology Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK.
J Antimicrob Chemother. 2007 Aug;60 Suppl 1:i63-8. doi: 10.1093/jac/dkm161.
Although a third of the public still believe that antibiotics work against coughs and colds, simply getting the public to believe otherwise may not be enough to reduce the level of prescribing. The large Department of Health sponsored household survey demonstrated that those with a greater knowledge about antibiotics were no less likely to be prescribed an antibiotic, and although those with increased knowledge about antibiotics were more likely to complete a course they were also more likely to self-medicate and to keep left-over antibiotics. Future campaigns that are aimed at reducing the level of prescribing should be focused towards those more likely to be prescribed antibiotics at present: younger women and those with a lower level of education. They should also examine and consider modifying consultation behaviour and other behavioural components involved in patient' expectations for antibiotics. This should include delayed antibiotic prescriptions. The easiest way to reduce the use of leftovers may be to shorten the course of antibiotics prescribed to 3 or 5 days. We should also promote a 'Do not recycle antibiotics' message towards the more highly educated, young women who are more likely to store, take and share antibiotics without advice.
尽管仍有三分之一的公众认为抗生素对咳嗽和感冒有效，但仅仅让公众改变这种看法可能不足以降低抗生素的处方量。卫生部发起的一项大型家庭调查显示，对抗生素了解较多的人被开抗生素的可能性并不低，而且虽然对抗生素了解更多的人更有可能完成疗程，但他们也更有可能自行用药并留存剩余的抗生素。未来旨在降低抗生素处方量的宣传活动应针对目前更有可能被开抗生素的人群：年轻女性和受教育程度较低的人。这些活动还应审视并考虑改变诊疗行为以及患者对抗生素期望中涉及的其他行为因素。这应包括延迟开具抗生素处方。减少剩余抗生素使用的最简单方法可能是将抗生素的疗程缩短至3至5天。我们还应向受教育程度较高、更有可能在无医嘱的情况下储存、服用和分享抗生素的年轻女性宣传“不要重复使用抗生素”的信息。
