抗生素处方-喹诺酮类与头孢菌素类（英文PPT）Antibiotic prescribing – especially quinolones and cephalosporinsPPT.ppt

Antibiotic prescribing – especially quinolones and cephalosporins ;Options for local implementationNPC. Key therapeutic topics – Medicines management options for local implementation. Second update July 2011 ;Key questions;What this is about?;Do we need to do something about the volume of antibiotic prescribing?;High use = high resistanceGoossens H, et al. Lancet 2005; 365: 579–87;Rates of MRSA on downward trend….;….and rates of C. difficile look encouraging….;….but with an interesting seasonal variation;What about quinolones and cephalosporins?;Trends in usage of quinolones in general practice in England ;E. coli resistance to ciprofloxacin has increased;Trends in usage of cephalosporins in general practice in England ;What is appropriate antibiotic prescribing?What does national guidance say?;Which antibiotic should be prescribed?.uk/web/HPAwebFile/HPAweb_C/1194947333801;Standing Medical Advisory CommitteeThe Path of Least Resistance. Department of Health, 1998;Harms of antibioticsalso see common infections respiratory tract elearning materials;What does NICE say for treating respiratory tract infections (RTIs)? (1)NICE. Respiratory tract infections. CG69. July 2008;Depending on clinical assessment of severity, patients in the following subgroups can also be considered for an immediate antibiotic prescribing strategy bilateral acute otitis media in children younger than 2 years acute otitis media in children with otorrhoea acute sore throat/acute pharyngitis/acute tonsillitis when three or more Centor criteria are present ;What strategies can be used to address over-prescribing?;Strategies for targeting volume of antibiotics prescribed for RTIs NICE. Respiratory tract infections. CG69. July 2008;Do antibiotics prevent complications?Petersen I, et al. BMJ 2007;335:982NPC. MeReC Rapid Review No. 23;Offer the patient reassurance and a safety net NICE. Respiratory tract infections. CG69. July 2008;Strategies to target those who will most benefit ;Ho