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伊拉克抗生素滥用与细菌耐药性综述。

A review of antibiotic misuse and bacterial resistance in Iraq.

机构信息

Clinical Pharmacy Department, College of Pharmacy, University of Baghdad, Baghdad, Iraq.

Pharmaceutics Department, College of Pharmacy, University of Baghdad, Baghdad, Iraq.

出版信息

East Mediterr Health J. 2024 Nov 3;30(10):663-670. doi: 10.26719/2024.30.10.663.

Abstract

BACKGROUND

Antimicrobial resistance poses a serious threat to healthcare globally. Reviewing current practice regarding antibiotic prescription and use is crucial to understanding antimicrobial resistance issues in Iraq and how to tackle them.

AIM

To review and analyse studies addressing antimicrobial resistance as well as antibiotic prescription, dispensing and use in Iraq.

METHODS

In June 2023, we searched Google Scholar for, and reviewed, empirical studies related to antibiotic use and antimicrobial resistance in Iraq.

RESULTS

Thirty-seven eligible studies published between 2012 and 2023 were included in the review. Multi-drug-resistant bacteria, such as E. coli and P. aeruginosa, were commonly reported by the studies. Most physicians in public hospitals prescribed antibiotics frequently and empirically without relying on culture and sensitivity tests, and community pharmacists often dispensed antibiotics to patients without prescriptions, indicating self-medication and misuse of antibiotics in Iraq. Antibiotic residuals were found in raw meat and drinking water. Although there were antimicrobial resistance control regulations and plans, they were not fully implemented.

CONCLUSION

This review shows that antimicrobial resistance and antibiotic misuse are serious problems in Iraq. The responsible authorities should work together to implement and enforce compliance to the antimicrobial resistance control plans using the One Health approach.

摘要

背景

抗菌药物耐药性对全球的医疗保健构成了严重威胁。审查当前的抗生素处方和使用情况对于了解伊拉克的抗菌药物耐药性问题以及如何应对这些问题至关重要。

目的

综述和分析伊拉克抗菌药物耐药性以及抗生素处方、配发和使用的研究。

方法

2023 年 6 月,我们在 Google Scholar 上搜索并回顾了与伊拉克抗生素使用和抗菌药物耐药性相关的实证研究。

结果

共纳入 37 项 2012 年至 2023 年发表的合格研究。研究报告中常见的多药耐药菌有大肠杆菌和铜绿假单胞菌等。公立医院的大多数医生经常凭经验而非基于培养和药敏试验开具抗生素,社区药剂师也经常在没有处方的情况下向患者配发抗生素,表明伊拉克存在自行用药和抗生素滥用的情况。在生肉和饮用水中也发现了抗生素残留。尽管有抗菌药物耐药性控制法规和计划,但并未得到全面执行。

结论

本综述表明,抗菌药物耐药性和抗生素滥用是伊拉克的严重问题。责任当局应共同努力,采用“同一健康”方法实施和执行抗菌药物耐药性控制计划,并确保其得到遵守。

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