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先前的抗生素相关不良反应并不会降低对上呼吸道感染进行抗生素治疗的期望。

Previous antibiotic-related adverse drug reactions do not reduce expectations for antibiotic treatment of upper respiratory tract infections.

机构信息

Department of Infectious Disease, Auckland City Hospital, New Zealand; Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.

Department of Infectious Disease, Auckland City Hospital, New Zealand.

出版信息

J Glob Antimicrob Resist. 2017 Sep;10:256-260. doi: 10.1016/j.jgar.2017.05.020. Epub 2017 Jul 18.

Abstract

BACKGROUND

Patients' expectations may influence prescribers' decisions about antibiotic prescribing for upper respiratory tract infection (URTI). We examined whether a history of an antibiotic related adverse drug reaction (aADR) influenced a person's perception about the safety of antibiotics or their expectation of receiving an antibiotic prescription for an URTI.

METHODS

We developed a questionnaire and surveyed 103 hospital inpatients, 38 of whom (37%) reported past experience of aADR.

RESULTS

Of the 88 participants who reported recent antibiotic use, participants with a history of aADR reported increased perception of harm from their last antibiotic treatment (P<0.05). Overall, 41/103 (40%) participants expected their doctors to prescribe antibiotics to treat an URTI. Participants' perceptions of antibiotic safety or expectation of antibiotic treatment for an URTI did not differ between those who had personal experience of an aADR compared with those with no history of aADR.

CONCLUSIONS

The almost universal belief that antibiotics are safe, beneficial medications, even among people with prior aADR, helps to explain the strong patient expectations for antibiotic treatment in a range of conditions. Educational campaigns about the prescription of antibiotics for viral URTI should include information that the risk of harm far outweighs any potential benefits.

摘要

背景

患者的期望可能会影响医生对治疗上呼吸道感染(URTI)的抗生素处方决策。我们研究了抗生素相关药物不良反应(aADR)的病史是否会影响人们对抗生素安全性的看法或他们对治疗 URTI 开具抗生素处方的期望。

方法

我们开发了一份问卷并对 103 名住院患者进行了调查,其中 38 名(37%)报告了过去发生过 aADR。

结果

在报告最近使用过抗生素的 88 名参与者中,有 aADR 病史的参与者认为他们上次抗生素治疗的危害增加(P<0.05)。总体而言,103 名参与者中有 41 名(40%)期望医生开抗生素治疗 URTI。与没有 aADR 病史的参与者相比,有个人 aADR 病史的参与者对抗生素安全性的看法或对治疗 URTI 使用抗生素的期望并无差异。

结论

即使是在有 aADR 病史的人中,也几乎普遍认为抗生素是安全且有益的药物,这有助于解释在各种情况下患者对使用抗生素治疗的强烈期望。针对病毒性 URTI 开具抗生素处方的教育活动应包括有关伤害风险远远超过任何潜在益处的信息。

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