CDC：1/3抗生素處方是不必要的

  ——最近CDC數(shù)據(jù)顯示，門診濫用抗生素的比例很大

譯者：李元葉、鄧糧

審核：陳志錦

For Immediate Release: Tuesday, May 3, 2016

http://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html

2016年5月3日 即時發(fā)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.

       根據(jù)今天疾病預(yù)防控制中心 (CDC) 與皮尤慈善信托基金和其他公共衛(wèi)生、醫(yī)療專家聯(lián)合發(fā)布在《美國醫(yī)學(xué)會雜志 (JAMA)》 上的最近數(shù)據(jù)顯示，在美國至少30%的抗生素處方是不必要的

        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.

       該研究分析了美國各地醫(yī)生診所和急診室的抗生素使用情況。CDC研究人員發(fā)現(xiàn)，大部分不必要抗生素處方的開具是由于病毒引起的呼吸系統(tǒng)疾病，包括有普通感冒、病毒性喉嚨痛、支氣管炎、鼻竇炎和耳部感染，但是這些疾病對抗生素并不敏感。每年有4700萬這類多余的處方，使患者處于不必要的過敏反應(yīng)甚至由艱難梭菌引起致命性腹瀉等危險之中。

       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.

       研究人員同時對成人與兒童以年齡和診斷評估不合理的抗生素使用率。這些數(shù)據(jù)將有助于改善未來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（醫(yī)學(xué)博士、公共衛(wèi)生碩士）說：“抗生素是救命藥，如果我們繼續(xù)沿著不合理使用的這條路走下去，在和危及生命的感染對抗中，我們將會失去最有力工具。失去這些抗生素的幫助，我們在治療致命性感染、癌癥、器官移植，以及拯救燒傷和外傷人員的能力將大打折扣”。

       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.

       阻止抗生素耐藥的斗爭

       2015年，白宮發(fā)布了《抗擊細菌耐藥國家行動計劃（CARB）》，其中一項目標(biāo)是到2020年，減少至少一半的門診不合理抗生素使用。這意味著，要達到CARB的這一目標(biāo)，必須在2020年消除15%的不合理抗生素處方（30%不合理抗生素處方的一半）。

        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:

       據(jù)評估，每年醫(yī)生診所和急診室開出的1.54億張抗生素處方中，有 30%是不必要的。這一發(fā)現(xiàn)將為改善門診抗生素處方和使用提供基準(zhǔn)數(shù)據(jù)。

      “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國家新發(fā)和人畜共患病中心醫(yī)療保健質(zhì)量促進司抗生素監(jiān)管辦公室主任、美國公共健康服務(wù)指揮官Lauri Hicks, DO說：“設(shè)定減少門診不必要抗生素使用的國家目標(biāo)，是改善抗生素使用和保護患者中關(guān)鍵的第一步。我們整個醫(yī)療系統(tǒng)必須繼續(xù)共同努力，確保僅在必要時使用抗生素；并在有需要使的前提下，正確選擇抗生素的種類、劑量和持續(xù)時間”。

         Health care professionals, health systems, and patients must take these actions to improve antibiotic use:

       1 .為改善抗生素的合理使用，醫(yī)務(wù)人員、衛(wèi)生系統(tǒng)和患者必須采取以下措施：

      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 .在適當(dāng)?shù)臅r候，門診醫(yī)務(wù)人員可以在診療過程中評估其用藥習(xí)慣和實施抗生素監(jiān)管，例如觀察等待或推遲開處方。

      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. 衛(wèi)生系統(tǒng)可以通過提供交流培訓(xùn)、臨床決策支持、醫(yī)患教育和醫(yī)務(wù)人員工作反饋等方式，改善診所和門診的抗生素使用。

       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. 患者可以咨詢醫(yī)務(wù)人員，什么情況需要使用抗生素，或者什么情況下不需要使用。這些對話內(nèi)容應(yīng)該包括患者因使用抗生素導(dǎo)致耐藥菌感染的風(fēng)險。 

       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.

       美國國會議已經(jīng)意識抗擊抗生素耐藥性的迫切需要。在2016年財政年度，國會撥款1.6億美元成立新基金，用于CDC實施《抗擊細菌耐藥國家行動計劃》中的各項活動。

       有了這筆資金，為了打擊抗生素耐藥性的擴散，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. 加快推進每個州的疫情檢測和預(yù)防。

2. 加強追蹤抗生素使用、耐藥機制和耐藥菌感染。

3. 支持創(chuàng)新研究，以填補知識空白。

4. 告知醫(yī)務(wù)人員和廣大公眾相關(guān)抗生素耐藥性和合理使用抗生素知識。

5. 通過支持局部地區(qū)擴大和開展新項目和新活動，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.

針對醫(yī)務(wù)人員和患者抗生素監(jiān)管和合理使用相關(guān)信息可通過以下網(wǎng)址查詢：www.cdc.gov/getsmart。

轉(zhuǎn)自：

http://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html

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