PAACT课件.ppt

* * * This slide sets up a rationale for improved prescribing and community use of antibiotics “Why we’re all here.” Preview: Background and extent of the problem How we got here What can be done Resistance rates across Canada for MRSA and VRE have been increasing in past yrs, though now stabilized/decreasing – Thought to be due to infection control programs. (McGeer 2001) The prevalence of MRSA was less than 5% in most hospitals worldwide in the early 1970s but a decade later had increased to as much as 40% in many hospitals in the United States and Europe. The prevalence differs tremendously between the United States and Canada. (see next slide) * OVERVIEW OF PRSP throughout the world Slide demonstrates where would could possible end up if complacent about antibiotic resistance. Also , the prevalence of MRSA was less than 5% in most hospitals worldwide in the early 1970s but a decade later had increased to as much as 40% in many hospitals in the United States and Europe. The prevalence differs tremendously between the United States and Canada. * Slide meant to contrast how we’re trained to think vs. what we actually do. Suggest: Run down the “Ideal world” column relatively quickly, and ask “Does anyone disagree with, or have anything to add to, these prescribing principles?” Go more slowly down the “Real World” column, using the discussion to highlight decision-making dilemmas and difficulties in being certain about diagnoses and severity of illness in everyday practice. Use the opportunity to preview some of the content you’ll be presenting later on in specific clinical areas End with a clear statement about individual and social harm that’s inevitable with emerging antibiotic resistance - this sets up the next phase of the presentation. * Slide introduces concepts necessary to understand resistance. Natural selection - Particularly powerful for bacteria due to: Immense populations (millions per individual infection); Very short generat