CDC:1/3抗生素处方是不必要的
——最近CDC数据显示,门诊滥用抗生素的比例很大
译者:李元叶、邓粮
审核:陈志锦
For Immediate Release: Tuesday, May 3, 2016
http://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html
2016年5月3日 即时发布
At least 30 percent of antibiotics prescribed in the United States are unnecessary, according to new data published today in the Journal of the American Medical Association (JAMA) by the Centers for Disease Control and Prevention (CDC), in collaboration with Pew Charitable Trusts and other public health and medical experts.
根据今天疾病预防控制中心 (CDC) 与皮尤慈善信托基金和其他公共卫生、医疗专家联合发布在《美国医学会杂志 (JAMA)》 上的最近数据显示,在美国至少30%的抗生素处方是不必要的
The study analyzed antibiotic use in doctors’ offices and emergency departments throughout the United States. CDC researchers found that most of these unnecessary antibiotics are prescribed for respiratory conditions caused by viruses – including common colds, viral sore throats, bronchitis, and sinus and ear infections – which do not respond to antibiotics. These 47 million excess prescriptions each year put patients at needless risk for allergic reactions or the sometimes deadly diarrhea, Clostridium difficile.
该研究分析了美国各地医生诊所和急诊室的抗生素使用情况。CDC研究人员发现,大部分不必要抗生素处方的开具是由于病毒引起的呼吸系统疾病,包括有普通感冒、病毒性喉咙痛、支气管炎、鼻窦炎和耳部感染,但是这些疾病对抗生素并不敏感。每年有4700万这类多余的处方,使患者处于不必要的过敏反应甚至由艰难梭菌引起致命性腹泻等危险之中。
The researchers also estimated the rate of inappropriate antibiotic use in adults and children by age and diagnosis. These data will help inform efforts to improve antibiotic prescribing over the next five years.
研究人员同时对成人与儿童以年龄和诊断评估不合理的抗生素使用率。这些数据将有助于改善未来5年的抗生素使用。
“Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we’ll lose the most powerful tool we have to fight life-threatening infections,” said CDC Director Tom Frieden, M.D., M.P.H. “Losing these antibiotics would undermine our ability to treat patients with deadly infections, cancer, provide organ transplants, and save victims of burns and trauma.”
CDC 的Tom Frieden主任(医学博士、公共卫生硕士)说:“抗生素是救命药,如果我们继续沿着不合理使用的这条路走下去,在和危及生命的感染对抗中,我们将会失去最有力工具。失去这些抗生素的帮助,我们在治疗致命性感染、癌症、器官移植,以及拯救烧伤和外伤人员的能力将大打折扣”。
The fight to stop antibiotic resistance
In 2015, the White House released The National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), which set a goal of reducing inappropriate outpatient antibiotic use by at least half by 2020. This means that 15 percent of antibiotic prescriptions (or half of the 30 percent that are unnecessary) must be eliminated by 2020 to meet the CARB goal.
阻止抗生素耐药的斗争
2015年,白宫发布了《抗击细菌耐药国家行动计划(CARB)》,其中一项目标是到2020年,减少至少一半的门诊不合理抗生素使用。这意味着,要达到CARB的这一目标,必须在2020年消除15%的不合理抗生素处方(30%不合理抗生素处方的一半)。
As part of the effort to achieve the national goal, CDC researchers analyzed the 2010–2011 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine the number of outpatient visits resulting in antibiotic prescriptions by age, region, and diagnosis in the United States from 2010-2011. They found that:
据评估,每年医生诊所和急诊室开出的1.54亿张抗生素处方中,有 30%是不必要的。这一发现将为改善门诊抗生素处方和使用提供基准数据。
“Setting a national target to reduce unnecessary antibiotic use in outpatient settings is a critical first step to improve antibiotic use and protect patients,” said Lauri Hicks, D.O., director of the Office of Antibiotic Stewardship in the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC, and commander in the U.S. Public Health Service. “We must continue to work together across the entire health care continuum to make sure that antibiotics are prescribed only when needed, and when an antibiotic is needed that the right antibiotic, dose, and duration are selected.”
CDC国家新发和人畜共患病中心医疗保健质量促进司抗生素监管办公室主任、美国公共健康服务指挥官Lauri Hicks, DO说:“设定减少门诊不必要抗生素使用的国家目标,是改善抗生素使用和保护患者中关键的第一步。我们整个医疗系统必须继续共同努力,确保仅在必要时使用抗生素;并在有需要使的前提下,正确选择抗生素的种类、剂量和持续时间”。
Health care professionals, health systems, and patients must take these actions to improve antibiotic use:
1 .为改善抗生素的合理使用,医务人员、卫生系统和患者必须采取以下措施:
Outpatient health care providers can evaluate their prescribing habits and implement antibiotic stewardship activities, such as watchful waiting or delayed prescribing, when appropriate, into their practices.
2 .在适当的时候,门诊医务人员可以在诊疗过程中评估其用药习惯和实施抗生素监管,例如观察等待或推迟开处方。
Health systems can improve antibiotic prescribing in offices and outpatient facilities within their networks by providing communications training, clinical decision support, patient and health care provider education, and feedback to providers on their performance.
3. 卫生系统可以通过提供交流培训、临床决策支持、医患教育和医务人员工作反馈等方式,改善诊所和门诊的抗生素使用。
Patients can talk to their health care providers about when antibiotics are needed and when they are not. These conversations should include information on patients’ risk for infections by antibiotic-resistant bacteria.
4. 患者可以咨询医务人员,什么情况需要使用抗生素,或者什么情况下不需要使用。这些对话内容应该包括患者因使用抗生素导致耐药菌感染的风险。
Congress has recognized the urgent need to combat antibiotic resistance. In fiscal 2016, Congress appropriated $160 million in new funding for CDC to implement its activities listed in the National Action Plan for Combating Antibiotic-Resistant Bacteria.
美国国会议已经意识抗击抗生素耐药性的迫切需要。在2016年财政年度,国会拨款1.6亿美元成立新基金,用于CDC实施《抗击细菌耐药国家行动计划》中的各项活动。
With this funding, CDC is fighting the spread of antibiotic resistance by:有了这笔资金,为了打击抗生素耐药性的扩散,CDC采取了以下措施:
1.Accelerating outbreak detection and prevention in every state.
2.Enhancing tracking of antibiotic use and resistance mechanisms and resistant infections.
3.Supporting innovative research to address gaps in knowledge.
4.Informing providers and the general public about antibiotic resistance and appropriate antibiotic use.
5.Improving antibiotic use by supporting expansion and development of new programs and activities at the local level.
1. 加快推进每个州的疫情检测和预防。
2. 加强追踪抗生素使用、耐药机制和耐药菌感染。
3. 支持创新研究,以填补知识空白。
4. 告知医务人员和广大公众相关抗生素耐药性和合理使用抗生素知识。
5. 通过支持局部地区扩大和开展新项目和新活动,改善抗生素使用。
Information on antibiotic stewardship and appropriate antibiotic use for health care providers and patients can be found at www.cdc.gov/getsmart.
针对医务人员和患者抗生素监管和合理使用相关信息可通过以下网址查询:www.cdc.gov/getsmart。
转自:
http://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html
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