抗生素PPT课件（英文精品） TOWARDS THE RATIONAL USE OF ANTIBIOTICSPPT.ppt

TOWARDS THE RATIONAL USE OF ANTIBIOTICS Anahí Dreser London School of Hygiene and Tropical Medicine Department of Public Health Policy Irrational antibiotic use and its consequences Common problems related with antibiotic use are: Over prescribing (giving antibiotics when it is not needed) Inappropriate selection and dosing by health care providers Unfettered access to antibiotics by consumers, self-medication The inappropriate use of antibiotics contributes to: Adverse clinical outcomes Global spread of antimicrobial resistance Unnecessary expenditures by consumers Heavy economic burden to health-care systems The case of Mexico (I) Middle-income country, 10th strongest world economy, 10th largest pharmaceutical market. BUT: important inequities, 40% of the population below the poverty line. Only 45% of the population have access to social security. Self-care, including self-medication, represents the most frequent (60%) response to illness. Private pharmacies play an important role. Undergoing epidemiological transition. However, respiratory tract infections and intestinal infections are still the main causes of general morbidity and under-five mortality. Commercialisation of 67 antibiotics in 305 brand names. Only one third are in the Essential Drug List, and 13% are irrational drug combinations. Widespread use of new generation antibiotics. Leyva, R., Consumo de medicamentos en farmacias privadas de Mexico. (Mimeo), Mexico, 2002. The case of Mexico (II) Drugs: 40% of public and private expenditure on health Antibiotics: largest group of drugs sold in private drugstores, half of them without prescription. Antibiotics are prescribed in 79% of the encounters with general practitioners. Resistance to common pathogens: the case of S. pneumoniae Prevalence of intermediate or high level resistance S. pneumoniae to penicillin, 1993-1997. Essential drug concept and the role of WHO in the promotion of rational drug use. Jonathan D. Quick, W