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

Appropriate Antibiotic Use and Antibiotic Resistance in the Community Kate Grant, MS Project Director Get Smart Virginia Virginia Department of Health Importance of Pneumococcal Infections in the U.S. Penicillin Resistance in S. pneumoniae, United States 1979-2000 Drug ResistantStreptococcus pneumoniae Resistance and Antibiotic Prescribing Risk factors for resistant S. pneumoniae are: young age ( 1 year) higher socioeconomic status day-care attendance recent receipt of antibiotics (2-5 times greater risk) CDC Treatment Guidelines /drugresistance/community/technical.htm Principles of Judicious Antimicrobial Use:Rhinitis and Sinusitis - Key Messages Rhinitis: antibiotics should not be given for viral rhinosinusitis Sinusitis: prolonged URI symptoms more severe URI symptoms (i.e. facial pain or swelling, high fever) antibiotic treatment with the most narrow-spectrum agent Principles of Judicious Antimicrobial Use:Pharyngitis - Key Messages Diagnose as group A strep Penicillin is the drug of choice in treating group A strep use erthromycin if penicillin allergic Principles of Judicious Antimicrobial Use:Cough and Bronchitis - Key Messages Cough/bronchitis rarely needs antibiotics Antibiotic treatment for prolonged cough (10 days) may be needed Mycoplasma pneumonia- use macrolide agent for children 5 Appropriate Antibiotic Use Summary Only prescribe antibiotic therapy when clearly beneficial Use an appropriate (targeted) agent Use the appropriate dose and duration HEDIS Performance Measures National Committee for Quality Assurance Two measures for children URI diagnosis: rate of antibiotic prescribing, 3 mos – 18 yrs Pharyngitis diagnosis: rate of group A strep tests given to 2-16 y/o who are prescribed antibiotics Pilot testing completed; public comment period for draft measures closed March 21, 2003 CDC Lessons Learned Prescribers and patients are all part of the problem Interventions must target both groups Not everyon