感冒不舒服，很多人都会习惯性要医生开点头孢、阿莫西林等抗菌类药物。今后，医生不会轻易满足患者在这方面的要求了。但是在昆明多家药店，顾客连处方都不用出具就可以直接购买。

Cold uncomfortable，Many people will habitual to doctors to prescribe some cephalosporins、Amoxicillin antibacterial drugs, etc。In the future，The doctor will not easily satisfy the requirements of patients in this respect。But in kunming is home to more than a pharmacy，Customers are not even prescription issued by can directly purchase。

管 理 Tube Richard

　　三级权限给医生上把锁 Level 3 access to the doctor on lock

　　《办法》实施后，昆明的医院是怎样执行的？

《way》After implementing the，Kunming hospital is how to perform？

　　省第一人民医院药学科主管医师张志清介绍，医院把抗菌药物分为非限制使用、限制使用和特殊使用三级，进行分级管理，明确各级医师使用抗菌药物的处方权限。通过三级权限管理，就像给开处方的医生上了一把“锁”，未按规定开具抗菌药物处方的将被取消处方权。

Province first people's hospital medicine discipline ZhangZhiQing introduces the competent physicians，The hospital antimicrobial divided into the limiting the use of、Limiting the use of and special use level 3，Were classified management，Clear doctors use of antimicrobial agents at all levels of the prescription permissions。Through the level 3 rights management，As to the prescriptions of the doctor“lock”，Not according to stipulations antimicrobial prescription issued the ChuFangQuan will be cancelled。

　　非限制使用的抗菌药物：最常见的有头孢类的头孢唑啉，还有青霉素、阿莫西林等，安全性比较好，但是能治的感染也是有限的。只要取得执业医师执照就可以给病人使用。

The limiting the use of antibacterial drugs：The most common are cephalosporin of cefazolin Lin was，And penicillin、Amoxicillin, etc，Security is better，But can cure infections is limited。As long as get practicing doctors can give patients use license。

　　限制使用的抗菌药物：是指对青霉素治不了的复杂感染，就要用这类抗菌谱更广、抗菌作用更强的药来治疗，市民比较熟悉的有罗红霉素等。需要主治医师以上级别的医生才能给病人开，市民也不可以随便买来吃。

Limiting the use of antibacterial drugs：Refers to penicillin is no cure for the complex infection，To use this kind of antibacterial spectrum more widely、Antimicrobial function stronger drugs to treat，People familiar with the luo erythromycin, etc。Need to the attending physician level of above a doctor can open to the patient，People can't literally buy to eat。

　　特殊使用的抗菌药物：针对严重感染，使用前要做药物敏感实验，如果敏感才使用，如果不敏感耐药就不再选用。这类药的耐药比较严重，比如四环素等。要副高级以上职称的医师，也就是副主任、主任才能给病人使用。

Special use antibacterial drugs：For serious infection，Use should be done before the drug sensitive experiment，If sensitive to use，If not sensitive resistance will no longer use。This type of drug resistance is more serious，Such as tetracycline, etc。Four more titles to the doctor，Also is assistant director、Director to give patients use。

　效 果 Effect fruit

　　住院患者抗菌药月使用率降两成 Hospitalized patients on antibiotic use twenty percent drop

　　记者了解到，《办法》实施之前，省卫生厅就在《2011年云南省抗菌药物临床应用专项整治活动实施方案》中提出了对抗菌药物使用“限品种、限用量、限级别”，设置了“硬指标”，严格控制抗菌药物品规数量。

The reporter understands，《way》Before implementation，In the provincial department《2011 antibacterial drugs for clinical use in yunnan province special three-month campaign plan》To put forward the application of antimicrobial agents“Limit varieties、Limited amount、Limited level”，set“Hard Numbers”，To strictly control the antibiotic items rules quantity。

　　三级医院的抗菌药物品种被压缩到50种，二级医院只有35种。三代及四代头孢菌素(含复方制剂)类抗菌药物口服剂型不超过5个品规，碳青霉烯类抗菌药物注射剂型不超过3个品规。而在以前，三级医院临床常用的抗菌药种类在100种左右，二级医院也有70至80种。整治新规的出台，意味着近一半抗菌药物被清退。

Level 3 hospital antimicrobial varieties of compressed to 50，Level 2 hospital only 35。Three generations and the fourth generation cephalosporin(Including compound preparations)Antibacterial drugs dosage forms of oral no more than five product rules，Carbapenems are the antibacterial injection drug dosage form of not more than three product rules。And in the past，Level 3 hospital clinical common antibiotic in 100 or so species，Of the second class hospitals also have 70 to 80。The new rule to come on stage，Means that nearly half of antimicrobial agents to repel was。

　　经过一年的抗菌药物临床应用专项整治，云南二级以上医院抗菌药物使用率和使用强度均有明显下降。云南三级医院住院患者抗菌药物月使用率由原来的80%下降到55%。二级医院门诊处方抗菌药物使用率由去年10月的22%下降到目前的12.8%，住院患者抗菌药物使用率从去年10月的80.4%下降到56.2%。

After a year of antibiotic drugs for clinical use special renovation，Yunnan second class above hospital antimicrobial usage and use strength are a decreasing。Yunnan level 3 hospital patients on antimicrobial usage from 80% down to 55%。Level 2 hospital outpatient service antimicrobial usage prescription from last year to 22% in October to 12.8% now，Patients in hospital antimicrobial usage from October last year, 80.4% to 56.2%。

　　省卫生厅相关负责人介绍，今后，云南执业医师及药师必须经过严格抗菌药物临床应用培训并考核合格，才能被授予相应级别的抗菌药物处方权或调剂资格，并严禁超处方权和违反程序使用抗菌药物。医院如不合理使用抗菌药，还将影响等级评审。

Provincial department of relevant controller introduces，In the future，Yunnan practicing doctors and pharmacists must pass strict antibacterial drugs in clinical application training and passed the examinations，Can be conferred appropriate levels of antimicrobial agents ChuFangQuan or dispensing qualification，And it is strictly prohibited to super ChuFangQuan against procedures and use antimicrobial agents。The hospital as improper use antibiotic，Will also influence rank evaluation。

　难 题 Difficult problem

　　“最严限抗令”限不住药店 “The most strict limit of make”Limit not pharmacy

　　但是对抗菌药使用问题，光转变医生的观念就行了吗？抗菌药的出处可不只是医院。《办法》规定，对于抗生素处方药，无论是零售药店向患者出售还是患者在零售药店购买，都必须出示医生处方。

But to use antibiotic，Change the concept of light doctor will do？The origin of antibiotic didn't just hospital。《way》provisions，For antibiotic prescription drugs，Whether retail pharmacy to patients in the retail pharmacies sell or patients purchase，Must be without a prescription。

　　但是记者走访了昆明市新闻路上的几家药店后发现，药店对来购买抗生素类药品的顾客并没有太严格的规定和要求，只要求顾客说说症状，连处方都不用出具就可以购买了，还有的店员连症状都不用描述，顾客点名要什么就给拿什么，也不告诉顾客抗生素类药品的副作用和用法用量。有的市民则什么是抗生素都不甚了解，更别说抗生素的危害，他们只知道嗓子疼了哪里发炎了就买消炎药吃，不知道这类药吃多了会有危害。

But the reporter interviewed kunming on the way of several news after a pharmacy found，Pharmacy to buy antibiotic drugs to the customers and not too strict regulations and requirements，Only request customers about symptoms，Even the prescription all need not issue can buy，The clerk even symptoms and don't have to describe，Customers to take what specifically requested??????，Also don't tell customers antibiotic drugs side effects and usage and dosage。Some citizens are what is antibiotics ever know，Let alone the harm of antibiotics，They only know where have a sore throat infection buy antiphlogistic medicine to eat，Do not know this kind of medicine to eat many will have the hazards。

　　在位于渔户村的一家大药房，记者以嗓子发炎为由购买消炎药，店内的导购员二话不说就拿出红霉素片，并称这个的效果比阿莫西林好。关于8月1日开始实施的《办法》，药店的销售人员表示还不知道。看来，要做好限制抗菌药的使用，不仅要给医生上把“锁”，还需要给药店也念一念“紧箍咒”。(王劲松 张婧姮）

Located in the village of YuHu in a large pharmacy，Reporter by a sore throat by buying expectorant，The store 导购员 of a word he got out of erythromycin，Saying this effect than amoxicillin is good。On August 1 st《way》，A pharmacy sales staff said they still don't know。look，To do well the limit the use of antibiotic，Not only to the doctor“lock”，Also need to give a pharmacy also read a“inhibitions”。(Wang jinsong ZhangJing Heng）