Department of Internal Medicine, General Hospital of Heraklion "Venizeleio-Pananeio", Leoforos Knossou, Heraklion, 71409, Greece.
General Medicine, University Hospital of Heraklion, Heraklion, 71410, Greece.
J Infect Public Health. 2019 Jul-Aug;12(4):460-464. doi: 10.1016/j.jiph.2019.03.017. Epub 2019 Apr 10.
Both antimicrobial consumption and antimicrobial resistance are very high in Greece, ranking among the highest of Europe. The link between antimicrobial consumption and resistance is well-known. Here, we discuss the reasons of antimicrobial overuse in Greece in the community (such as self-medication, dispersion of antibiotics by pharmacies without prescription, over-prescription by physicians, patient expectations and liability pressure) and we explore the misuse of antibiotics for common community infections. Furthermore, we discuss how such overuse/misuse can drive antimicrobial resistance, using methicillin-resistance in Staphylococcus aureus as an example. S. aureus is one of the pathogens with high rates of resistance in Greece. Comparing the rate of antimicrobial susceptibility to non-beta lactams between methicillin-resistant and methicillin-sensitive S. aureus we highlight the antibiotics that have the potential to drive methicillin-resistance through co-selection. Based on the above we identify targets for intervention in order to reduce antimicrobial overuse/misuse in the community in Greece.
希腊的抗菌药物消费和耐药情况都非常高，在欧洲属于最高之列。抗菌药物消费和耐药之间存在着密切的联系。在这里，我们讨论了社区中抗菌药物过度使用的原因（如自我用药、药店未经处方分发抗生素、医生过度处方、患者期望和责任压力），并探讨了抗生素在常见社区感染中的滥用情况。此外，我们还讨论了这种过度使用/滥用如何导致抗菌药物耐药性，以耐甲氧西林金黄色葡萄球菌（MRSA）为例。MRSA 是希腊耐药率较高的病原体之一。通过比较耐甲氧西林和甲氧西林敏感的金黄色葡萄球菌对非β-内酰胺类抗菌药物的药敏率，我们强调了那些有可能通过共选择导致耐甲氧西林的抗生素。基于以上内容，我们确定了干预目标，以减少希腊社区中抗菌药物的过度使用/滥用。
