Langford B J, Daneman N, Leung V, Wu J H C, Brown K, Schwartz K L, Garber G
Public Health Ontario, Toronto, Ontario, Canada.
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
JAC Antimicrob Resist. 2019 Nov 5;1(3):dlz059. doi: 10.1093/jacamr/dlz059. eCollection 2019 Dec.
Antimicrobial resistance (AMR) poses a threat to modern medicine, but there are challenges in communicating its urgency and scope and potential solutions to this growing problem. It is recognized that AMR has a 'language problem' and the way in which healthcare professionals communicate about AMR may not always resonate with patients. Many patients are unaware that antibiotics can have detrimental effects to those beyond the recipient, due to transmission of drug-resistant organisms. The overestimation of benefits and underestimation of risks helps to fuel demand for antibiotic use in situations where they may be of little or no benefit. To better communicate risks, clinicians may borrow the term 'second-hand' from efforts to reduce smoking cessation. We present several examples where antibiotics themselves have second-hand effects beyond the individual recipient in hospitals, long-term care homes and the community. Incorporation of the concept of the second-hand effects of antibiotics into patient counselling, mass messaging and future research may help facilitate a more balanced discussion about the benefits and risks of antibiotic use in order to use these agents more appropriately.
抗菌药物耐药性（AMR）对现代医学构成了威胁，但在传达其紧迫性、范围以及针对这一日益严重问题的潜在解决方案方面存在挑战。人们认识到AMR存在“语言问题”，医疗保健专业人员谈论AMR的方式可能并不总能引起患者的共鸣。许多患者并未意识到，由于耐药生物体的传播，抗生素可能会对接受者以外的人产生有害影响。对益处的高估和对风险的低估助长了在抗生素可能几乎没有益处或根本没有益处的情况下对抗生素使用的需求。为了更好地传达风险，临床医生可能会从减少戒烟的努力中借用“二手”这个术语。我们给出了几个例子，说明抗生素在医院、长期护理机构和社区中，除了个体接受者之外还会产生二手效应。将抗生素二手效应的概念纳入患者咨询、大众宣传和未来研究中，可能有助于促进关于抗生素使用益处和风险的更平衡讨论，以便更恰当地使用这些药物。
