Yonts Alexandra B, Kronman Matthew P, Hamdy Rana F
Division of Infectious Diseases, Children's National Medical Center, Washington, D.C., United States.
Division of Pediatric Infectious Diseases, University of Washington, Seattle, WA, United States.
Curr Probl Pediatr Adolesc Health Care. 2018 Nov;48(11):272-288. doi: 10.1016/j.cppeds.2018.09.002. Epub 2018 Oct 16.
Antibiotics are one of the most commonly prescribed classes of medication for children and adolescents. While they are arguably the most powerful tool we possess against bacterial infections, they are frequently given to children whose illnesses are due to viruses or other non-infectious etiologies. When antibiotics are not used judiciously, the consequences can be serious and accumulate over time. This review article quantifies the burden of antimicrobial use in the pediatric outpatient setting in the United States, reviews recommended first line antibiotic regimens for common outpatient pediatric and adolescent conditions, investigates the reasons for inappropriate prescribing of antibiotics in outpatient healthcare settings, and explores the range of consequences of overuse and inappropriate use of antibiotics, from adverse drug reactions to impact on the microbiome to rising rates of antimicrobial resistance in common ambulatory conditions.
抗生素是儿童和青少年最常被处方的药物类别之一。虽然它们可以说是我们对抗细菌感染最有力的工具，但经常被用于患有由病毒或其他非感染性病因引起疾病的儿童。如果抗生素使用不当，后果可能很严重，且会随着时间累积。这篇综述文章量化了美国儿科门诊环境中抗菌药物使用的负担，回顾了针对常见儿科和青少年门诊疾病推荐的一线抗生素治疗方案，调查了门诊医疗环境中抗生素处方不当的原因，并探讨了抗生素过度使用和不当使用的一系列后果，从药物不良反应到对微生物群的影响，再到常见门诊疾病中抗菌药物耐药率的上升。
