MMWR Morb Mortal Wkly Rep. 2011 Sep 2;60(34):1153-6.
In 2003, the Institute of Medicine identified antibiotic resistance as a key microbial threat to health in the United States and recommended promoting appropriate antibiotic use as an important strategy to address this threat. Antibiotic use contributes to development of antibiotic resistance on both the individual and country level. To examine trends in pediatric antibiotic prescribing in physician offices, CDC analyzed data from the National Ambulatory Medical Care Survey (NAMCS) for the period 1993-1994 to 2007-2008. This report summarizes the results of that analysis, which found that antibiotic prescribing rates for persons aged ≤ 14 years who had visited physician offices decreased 24% from 300 antibiotic courses per 1,000 office visits in 1993-1994 to 229 antibiotic courses per 1,000 office visits in 2007-2008. Among the five acute respiratory infections (ARIs) examined, antibiotic prescribing rates decreased 26% for pharyngitis and 19% for nonspecific upper respiratory infection (common cold); prescribing rates for otitis media, bronchitis, and sinusitis did not change significantly. Although the overall antibiotic prescribing rate for persons aged ≤ 14 years has decreased, the rate remains inappropriately high. Further efforts are needed to decrease inappropriate antibiotic prescribing for persons aged ≤ 14 years.
2003 年,美国医学研究所将抗生素耐药性确定为对美国健康的主要微生物威胁,并建议推广适当使用抗生素作为应对这一威胁的重要策略。抗生素的使用导致个体和国家层面的抗生素耐药性的发展。为了研究儿科医生办公室中抗生素处方的趋势,疾病预防控制中心分析了 1993-1994 年至 2007-2008 年期间全国门诊医疗调查(NAMCS)的数据。本报告总结了该分析的结果,发现 1993-1994 年,每 1000 次门诊就诊中,有 300 个抗生素疗程用于年龄≤14 岁的就诊者,而 2007-2008 年,这一比例下降了 24%,降至 229 个抗生素疗程。在所研究的五种急性呼吸道感染(ARI)中,咽炎的抗生素处方率下降了 26%,非特异性上呼吸道感染(普通感冒)下降了 19%;中耳炎、支气管炎和鼻窦炎的处方率没有显著变化。尽管年龄≤14 岁者的总体抗生素处方率有所下降,但仍高得不合理。需要进一步努力减少年龄≤14 岁者不合理的抗生素处方。