Berild Dag, Haug Jon Birger
Infeksjonsseksjonen Medisinsk klinikk Aker universitetssykehus 0514 Oslo.
Tidsskr Nor Laegeforen. 2008 Oct 23;128(20):2335-9.
The Norwegian antibiotic policy emphasises use of narrow-spectrum antibiotics and has been regarded as successful. We have a low occurrence of antibiotic resistance, but hospital use of antibiotics in general, and broad-spectrum antibiotics specifically, has increased substantially the last 10 years. We now see a trend towards increasing antibiotic resistance, which will inevitably lead to the same serious resistance problems in Norway as abroad.
We have assessed resistance profiles for the most common human pathogens in Norway in the light of literature retrieved through a non-systematic search of PubMed and Norwegian literature on rational antibiotic use. The article emphasises pharmacodynamic and pharmacokinetic aspects, as well as ecological side effects of antibiotics and discusses rational treatment of the most common infections in Norwegian hospitals.
Most research in this context is performed in settings with different antibiotic resistance patterns and attitudes towards antibiotic treatment than in Norway; few studies have focused on rational antibiotic use in Norwegian hospitals. We conclude that "old-fashioned" narrow-spectrum antibiotics can still be used in Norwegian hospitals, as there is little resistance to these agents.
It is still possible to treat most infections in Norwegian hospitals with narrow-spectrum antibiotics. We encourage physicians to adhere to the Norwegian antibiotic therapy tradition.
挪威的抗生素政策强调使用窄谱抗生素，且被认为是成功的。我们国家抗生素耐药性的发生率较低，但在过去10年里，医院总体抗生素的使用，尤其是广谱抗生素的使用大幅增加。我们现在看到抗生素耐药性呈上升趋势，这将不可避免地在挪威导致与国外同样严重的耐药问题。
我们根据通过对PubMed以及挪威关于合理使用抗生素的文献进行非系统检索而获取的文献，评估了挪威最常见人类病原体的耐药谱。本文强调了抗生素的药效学和药代动力学方面，以及抗生素的生态副作用，并讨论了挪威医院最常见感染的合理治疗方法。
在这方面的大多数研究是在与挪威抗生素耐药模式和对抗生素治疗态度不同的环境中进行的；很少有研究关注挪威医院的合理抗生素使用。我们得出结论，“老式”窄谱抗生素在挪威医院仍可使用，因为对这些药物几乎没有耐药性。
在挪威医院，使用窄谱抗生素仍有可能治疗大多数感染。我们鼓励医生坚持挪威的抗生素治疗传统。
