Mazzon Davide
Direttore Dipartimento "Chirurgia" e Presidente Comitato Etico per la Pratica Clinica ULSS 1 Regione Veneto.
Recenti Prog Med. 2016 Feb;107(2):71-4. doi: 10.1701/2152.23268.
Common goods refer to goods that may be used by anyone belonging to the community that has use rights over a commons and are fundamental to people's lives. Appropriate measures for safeguarding common goods should be undertaken, also for the benefit of future generations. Drugs in general, and antibiotics in particular, should be considered a common good as well. However, antibiotic use confined to the individual health benefit not only leads to less favorable outcomes for the society but also results in the development of antimicrobial resistance in the individual patient. This phenomenon is termed "tragedy of the commons" and identifies the impossibility of achieving over time the optimal treatment for each individual subject/patient. As a consequence, pursuing individual interests may lead to societal detriment. Conversely, restricting antibiotic prescriptions (e.g., avoiding overuse or misuse of last-generation antibiotics for the treatment of an infection) is not harmful for the individual, would benefit society with increased efficacy, and does not favor the emergence of antibiotic resistance. In this editorial, several suggestions as to how antibiotics should be appropriately used are provided in accordance with distributive justice principles, where individual and social interests meet.
公共物品是指任何属于对共有资源拥有使用权的社区的人都可以使用的物品，并且对人们的生活至关重要。应该采取适当措施来保护公共物品，这也是为了子孙后代的利益。一般来说，药物，尤其是抗生素，也应被视为公共物品。然而，仅为个人健康利益而使用抗生素不仅会给社会带来不太理想的结果，还会导致个体患者产生抗菌药物耐药性。这种现象被称为“公地悲剧”，它表明随着时间的推移，无法为每个个体受试者/患者实现最佳治疗。因此，追求个人利益可能会导致社会受损。相反，限制抗生素处方（例如，避免过度使用或滥用最后一代抗生素来治疗感染）对个人无害，会因疗效提高而使社会受益，并且不利于抗生素耐药性的出现。在这篇社论中，根据分配正义原则，在个人利益与社会利益相契合之处，就如何合理使用抗生素提供了一些建议。
