合理使用抗生素和社区抗生素耐药(英文)0Appropriate Antibiotic Use and Antibiotic Resistance in the Community讲解说明.ppt

This graph displays a 20 year look at penicillin nonsusceptible Invasive S. pneumonia rates. Resistance rates were only at an intermediate level in the early and late 80’s. However as we approach the early 90’s the nonsusceptible and intermediate resistance rates for S. pneumoniae start a sharp upward trend. This data has been provided by the Center for Disease Control and Prevention’s (CDC) Active Bacterial Core Surveillance Group (ABC’s). At nine Emerging Infections Program sites (EIPs), surveillance for ABCs is conducted for invasive bacterial diseases due to pathogens of public health importance. For each case of invasive disease in the study population, a case report with basic demographic information is filed and, in most cases, bacterial isolates from a normally sterile site from patients are sent to CDC for laboratory study. Drug resistant Streptococcus pneumoniae emerged in Spain and South Africa in the mid 80’s and it has only been in the last decade or so that we have seen these resistant strains in the United States. Research suggests that the increase in drug resistant streptococcus pneumoniae is due to antibiotics being used for viral infections. Antibiotic resistance is threatening the use of antibiotics for common infections and in some cases require clinicians to choose more expensive and invasive treatments. A study in Pediatrics found the risk factors for acquisition of resistant S. pneumoniae to be: -Young age (1 year) -Higher economic status -day-care attendance -recent use of antibiotics Many research studies suggest that recent use of antibiotics is a major risk factor for acquiring a resistant strain. The risk is somewhere between 2 and 5 times greater for children who have recently received antibiotics (up to 6 months before). Dowell, Am Fam Phys 1997;55:1647 A study by Barden published in Clinical Pediatrics looked at 8 focus groups of patients and physicians about why antibiotics were wanted and prescribed. The study