Calva J, Bojalil R
Department of Infectious Diseases, Institute Nacional de la Nutricion, Mexico DF, Mexico.
Soc Sci Med. 1996 Apr;42(8):1121-8. doi: 10.1016/0277-9536(95)00385-1.
In developing countries, antibiotics are the most common drugs sold, and some data suggest that they are frequently misused. In order to describe the pattern of antibiotic use in a periurban community in Mexico City, 1659 randomly-selected households were visited and an interview with the housewife was carried out. Six local drugstores also were selected at random. A social worker made six visits to each pharmacy, observed the events during the purchase of the drug and applied a structured questionnaire to the customer immediately after the transaction. Of 8279 individuals, 425 (5%) said that they had used at least one antimicrobial in the preceding 2 weeks and antibiotics were the majority (29%) of the drug sales. The main perceived reasons for drug use were acute respiratory tract ailments and gastroenteritis. Interviewees reported that antibiotic therapy was given in 27% of respiratory diseases and in 37% of all diarrheal episodes. The drugs most commonly reported were: penicillins, erythromycin, metronidazole, neomycin, cotrimoxazole and tetracyclines. While self-medication and drug purchases without medical prescription were common, the majority of antibiotics were prescribed by a physician. Approximately two thirds of individuals using an antibiotic said they had used it for less than 5 days and 72% of the purchases were for insufficient quantities of drugs. Our data suggest that antibiotics are frequently misused and they support the need to assess the determinants of self-medication, health-seeking behavior and physician prescribing practices. The need for effective educational programs to improve prescribers' decisions is stressed.
在发展中国家，抗生素是最常见的在售药品，一些数据表明它们经常被滥用。为了描述墨西哥城一个城郊社区的抗生素使用模式，研究人员走访了1659户随机抽取的家庭，并与家庭主妇进行了访谈。还随机挑选了六家当地药店。一名社会工作者对每家药店进行了六次走访，观察购药过程中的情况，并在交易完成后立即向顾客发放一份结构化问卷。在8279名受访者中，425人（5%）表示他们在过去两周内至少使用过一种抗菌药物，抗生素占药品销售额的大部分（29%）。人们认为用药的主要原因是急性呼吸道疾病和肠胃炎。受访者报告称，27%的呼吸道疾病和37%的腹泻病例接受了抗生素治疗。最常提及的药物有：青霉素、红霉素、甲硝唑、新霉素、复方新诺明和四环素。虽然自我药疗和无处方购药很常见，但大多数抗生素是由医生开的。使用抗生素的人中约三分之二表示用药时间不到5天，72%的购药量不足。我们的数据表明抗生素经常被滥用，这支持了评估自我药疗、求医行为和医生开方习惯的决定因素的必要性。强调了开展有效教育项目以改善开方者决策的必要性。
