相关报道： Related reports：儿童是抗菌药滥用“重灾区” 不发烧最好不吃药

Child abuse is antibiotic“hard-hit” A fever had better not take medicine

　　

史上最严抗菌药物“限令” 实施半月能管住过度用药吗？ History's most severe antibacterial drugs“asked” Implement and half months can take control excessive medication？

　　

本报记者探访发现，正规大医院有所节制，但药店执行时多有“变通” Our reporter found that visit，Normal big hospital somewhat abstemious，But more than the execution of the drugstore“flexible”

　　8月1日，卫生部颁布的《抗菌药物临床应用管理办法》(以下简称《办法》)正式实施。这则被称为史上最严“限抗令”的《办法》规定，医生必须根据患者的症状、体征及血、尿常规等实验室检查结果，初步诊断为细菌性感染者，才能应用抗菌药物，否则将被限制、取消处方权，甚至被暂停执业活动。

August 1,，Promulgated by the ministry《Measures for the administration of antimicrobial drugs for clinical use》(Hereinafter referred to as《way》)Formally implementing。This is called the most heavily in history“Limit resistance to”of《way》provisions，The doctor must according to the patient's symptoms、Signs and blood、Routine urine and laboratory results，A primary diagnosis of bacterial infections，To antibiotics，Or will be limited、ChuFangQuan cancel，Even suspended practice。

　　如今，“限抗令”实施近半个月，南京的各大医院和药店执行的情况到底怎样？昨天，扬子晚报记者对此进行了探访。

now，“Limit resistance to”Implement nearly half a month，Nanjing each big hospital pharmacy and the execution of the situation how, exactly？yesterday，Yangzi evening news reporter about this visit。

　　

药店 执行很宽松，有办法变通 Enterprise executive is more relaxed，A flexible way to

　　“限抗令”颁布后，药店是否严格遵守了要求？昨天下午，扬子晚报记者来到南京新街口附近的几家药店，惊讶地发现“上有政策下有对策”

“Limit resistance to”Promulgated after，Whether the drugstore abided by the requirements？Yesterday afternoon，Yangzi evening news reporter came to nanjing new street several nearby home a pharmacy，Was surprised to find that the“Policy XiaYouDuiCe”

　　一家药店：买头孢 没处方也能刷卡买

A drugstore：Buy cephalosporins prescription can also buy card no

　　“有头孢”(一种常用抗菌药)吗？扬子晚报记者问。店员的回复十分简洁，“刷医保卡还是自费？”

“Cephalosporins have”(A common antibiotic)?？Yangzi evening news reporter asked。The clerk reply very concise，“Brush card or medical expenses？”

　　这有什么区别吗？在店员的讲解下，记者才明白，原来“潜规则”是：自费付现金可以即刻就买到头孢，刷卡则需要凭处方来购买。“要是没有处方，系统里刷卡是刷不进去的。”店员明确表态。

What is the difference between this？In the sense of the shop assistant，The reporter just understand，The original“Unspoken rules”is：At one's own expenses to pay cash can instantly bought the cephalosporins，Brush card with a prescription to buy is need。“If no prescription，The system is to brush card will not go in。”The clerk specifically expressed a。

　　扬子晚报记者表示只想刷卡不想付现金，但药店店员依然不愿放弃这笔“生意”。“你要买几盒？如果就买两三盒，我们可以帮你操作一下，你刷卡照样能买。”听到记者回复只买一盒后，店员立刻就给记者开了付费收据，“就一盒，没事，你刷卡也能买。”

Yangzi evening news reporters just want to charge don't want to pay in cash，But drugstore clerk are still unwilling to give up the“business”。“You want to buy a few box？If buy two or three boxes，We can help you to operate it，You can still buy credit card。”Hear reporters reply only buy a box，Shop assistant immediately give reporters opened the payment receipt，“Just a box of，nothing，You can also buy credit card。”

　　

另一药店：买金霉素眼膏 店里就能给开处方 Another drugstore：Buy them aureomycin can give the store a prescription

　　在另一家规模更大的药店，记者要求购买一只金霉素眼膏。导购员表态，金霉素眼膏按照规定是需要医生处方的，如果没有处方不能购买。

In another larger drugstore，Reporter requirements buy a aureomycin them。导购员 comment，According to the regulation is them aureomycin require a doctor's approval，If no prescription cannot be bought。

　　就在记者准备转身走开时，店员称也有变通的模式：“我们店里有驻店医生，你可以在驻店医生这里检查一下，就可以买了。”

In the reporters ready to turn and walk away，The clerk says also have flexible mode：“Our store has resident doctor，You can store the doctor here in check，Can buy the。”

　　该店员告诉记者，需要处方来购买抗菌药是按照医保部门的严格规定来执行的，“必须要留下处方记录，如果没有处方记录而被查到了，我们会被处罚的。”

The clerk told reporters，Require a prescription to buy antibiotic is strict rules according to health care providers to execute，“Must leave prescription records，If no prescription records and was found here，We will be punished。”

　　

医院 一开抗菌药，电脑会“预警” Hospital a open antibiotic，Computer will“warning”

　　对于“限抗令”，南京的医院执行得如何呢？随后，扬子晚报记者来到南京一家三甲医院，“围观”了医生问诊到开药的全部过程。记者了解到，如果不是必要，正规大医院的医生不主动给患者开抗生素，但如果患者坚持要这种药，是有可能给开的。但医生只要开出抗菌药，电脑就会发出“预警提醒”。

for“Limit resistance to”，Nanjing hospital executed how？then，Yangzi evening news reporter came to nanjing a 3 armour hospital，“onlookers”The doctor to prescribe medicine by all the process。The reporter understands，If not necessary，Normal big hospital doctors don't offer patients prescribed antibiotics，But if patients insist that this medicine，Is likely to open。But doctors as long as uncle opened，The computer can issue“Warning remind”。

　　

患者坚持要抗生素，医生还是给开的 Patients insist on antibiotics，The doctor or to open

　　“给我开点头孢吧，这样好得快一点，不然太耽误上班。”一位重感冒的患者直截了当请求医生。值班医生再三讲清抗生素的危害和“限抗令”后，该患者依然表示“我是大人，一年就偶尔吃这么一两次没事。”记者看到，无奈之下医生手写开了处方。

“It gave me some cephalosporins，So good faster，Not really takes work。”A bad cold of the patients straightforward requests the doctor。The attending doctor repeatedly made clear the harm and antibiotics“Limit resistance to”after，The patient is said“I'm an adult，A year is occasionally eat so a two fine。”The reporter sees，But under the doctor has prescribed by hand。

　　但当医生将处方交由一旁的助手进行电脑检索时，该患者挂号开药的全部信息就出现了，头孢拉定也被“记录在案”。

But when the doctor will prescription to the assistant aside computer search，The patients registered prescriptions in all the information，Cephalosporins set was also pull“recorded”。

　　像这样的开药流程在三甲医院都已得到普遍的执行，医生开的所有药物都会立刻“入库”，当然也包括各种抗菌药物。“使用电脑系统即时开药还能给我们进行‘预警’，每天得针对不同的人开出处方，稍不留神就会出错，万一出现药物的搭配禁忌问题，系统会自动弹出一个对话框进行提醒，引起医生的注意。”这位值班医生告诉扬子晚报记者。

Such prescriptions flow in 3 armour hospital has got generally of execution，The doctor prescribed drugs will all at once“warehousing”，Of course also include all kinds of antimicrobial drugs。“Use the computer system to prescribe medicine can also give us immediately‘warning’，Every day according to different people to open the prescription，A bit not careful, you will make mistakes，In one thousand the collocation of the drug problem taboo，The system will automatically a dialog box to remind，Cause the attention of doctors。”The doctor told reporters on duty yangtse evening post。

　　对于抗菌类药物的使用，该医生并没有太多的避讳，“医生也不会过度开头孢或是其他药，但有时候患者的坚持也让我们有些为难。”

For the use of antibacterial drugs，The doctor and not too much taboo，“The doctor also won't be excessive open cephalosporins or other drugs，But sometimes the patient to also let us some difficult。”

　　“就连挂水都是很多人自己坚持要挂的。不少人吃一些中成药抵抗一下感冒就行了，但他们还是坚持要挂水，认为这样可以好得更快一些。”一位不愿意透露姓名的医生告诉记者。

“Even hang water are a lot of people to hang。Many people eat some traditional Chinese medicines against the cold will do，But they still insist hanging water，Thought it would be good faster。”An anonymous doctor told reporters。

　　

一感冒就吃头孢，这种想法不对 Catch a cold, eat cephalosporins，This wrong

　　江苏省中医院呼吸科史锁芳主任医师告诉记者，“使用头孢好得更快”的理解本身就是个错误。

Jiangsu province HuXiKe hospital ShiSuo of doctor of fang told reporters，“Use cephalosporins good faster”Understanding itself is a mistake。

　　“感冒也得分清种类，一般的感冒都是病毒感染，应该使用抗病毒药物；而抗菌药抵抗的是细菌感染。最常见的头孢类药物也有一到四代。”同时史主任补充，如果需要用抗生素，使用的药物应该是头孢一代、青霉素、红霉素、氧氟沙星等。

“A cold also have to distinguish types，The common cold is a virus infection，Should use antiviral drugs；And antibiotic resistance is bacterial infections。The most common cephalosporin drugs also have one to four generations。”At the same time history director added，If need to use antibiotics，Use of the drug should be added a generation、penicillin、erythromycin、Levofloxacin, etc。

　　“一感冒就选择头孢的做法显然不符合要求。”史锁芳明确表示。

“Catch a cold, choose the practice of cefazolin obviously does not meet the requirements。”ShiSuo fang make it clear。

　　

儿科和手术室，是抗生素的“重灾区” Pediatrics and the operating room，Is antibiotics“hard-hit”

　　“孩子的体质比较弱，动不动就感冒，但医生每次都给她挂头孢，我可着急了。”昨天，在一家医院的儿科门诊前，南京市民李女士告诉扬子晚报记者。

“The child's constitution are weak，Always cold，But every time the doctor to give her hang cephalosporins，I can try so hard the。”yesterday，In a hospital of the pediatric clinic before，Nanjing citizens ms. Li told reporters yangtse evening post。

　　记者了解到，儿科是头孢使用的“重灾区”。虽然执行了“限抗令”，但在南京一些小医院里，抗生素依然在使用。

The reporter understands，Pediatric is the use of cephalosporins“hard-hit”。Although the execution“Limit resistance to”，But in nanjing a few small hospital，Antibiotics are still in use。

　　专家告诉记者，其实小儿感冒大部分是病毒感染，不应该冒然使用抗菌药。如果出现咳嗽或是发低烧等症状，还是应该对症治疗。只有扁桃体化脓等有细菌感染症状，才可以使用抗菌药。

Experts told reporters，In fact most of children is a cold virus infection，Should not use antibiotic protects the。If a cough or a low grade fever and other symptoms，Or should be symptomatic treatment。Only the tonsils and purulent bacterial infection symptoms，Just can use antibiotic。

　　如今，抗菌药物用得比较多的另一个地方是手术室。扬子晚报记者了解到，在手术时，抗菌药物也普遍被用来抵抗细菌感染。“在手术之前半小时或一小时，我们会给病人推一针头孢手术室的人比较多，防止细菌感染还是必须的。”一位骨科医生告诉记者。

now，Antimicrobial drug use more another place is the operating room。Yangzi evening news reporter understanding to，When the operation in，Antibacterial drugs are widely used to resist bacteria infections。“Before the operation in half an hour or one hour，We will give patients pushing a needle in the operating cephalosporins person is more，Prevent bacterial infections or a must。”An orthopaedic surgeons told reporters。

　　

如何监督？ 省市卫生厅局都会定期监察 How to supervise？ Health TingJu regularly monitor provinces and cities

　　扬子晚报记者了解到，在《抗菌药物临床应用管理办法》开始实施之前，南京的各大三甲医院对于抗菌药物的使用都有着明确的限制。医生的处方“入库”后，医院还会根据“信息库”中的处方信息进行抽查。而省市卫生厅局也会定期派人对医院的抗菌药使用情况进行监察，如果发现使用过当的情况则会进行处理。

Yangzi evening news reporter understanding to，in《Measures for the administration of antimicrobial drugs for clinical use》Began to implement previous，Nanjing each big 3 armour hospital antimicrobial drugs for the use of a clear restrictions。The doctor's prescription“warehousing”after，According to the hospital“Information database”Prescribing information in the spot。And health TingJu will also regularly provinces and cities to the hospital sent antibiotic use for monitoring，If excessive use of the case is that will deal with them。

　　“没有哪个医生想靠多开抗菌药赚钱，医院的执行要按照一定的标准，但‘患者指挥医生’的困惑可能是‘限抗令’在执行过程中最需要加强和改善的地方。”一位知情人士说。

“No doctor wants to make money by additional antibiotic，The implementation of the hospital according to certain standards，but‘Patients command the doctor’Confusion may be‘Limit resistance to’In the process, it is necessary to strengthen and improve place。”A person familiar with the deal said。

　　

揭秘 Reveal the

　　

医生自己感冒，怎么处理呢？ The doctor himself cold，How to deal with it？

　　“我如果感冒，首先会大量喝水，不过度劳累，休息对感冒治疗是最重要的。”中大医院呼吸科主任林勇说。同时专家建议，发烧到38度左右，患者觉得不大放心时，不妨到医院检查一下血常规，看看血液中细菌感染的情况。“查出来是哪种细菌感染，再‘对症下药’是不错的选择。”东南大学附属中大医院呼吸科主任林勇告诉记者。

“If I catch a cold，First will drink large amounts of water，Don't overwork，Rest to the cold therapy is the most important。”HuXiKe zhongda hospital director Lin yong said。And experts suggest，A fever to 38 degrees or so，Patients feel very worried，Might as well to the hospital for an examination routine blood，Look at the blood bacteria infections。“To find out what kind of bacteria infection，again‘Suit the remedy to the case’Is a good choice。”Southeast university HuXiKe affiliated zhongda hospital director Lin yong told reporters。

　　

医生家的“小药箱”都有些啥药？ The doctor home“Small medicine”Are some what medicine？

　　呼吸科医生的家里都会准备哪些药物？林勇告诉记者，自己家中不会准备头孢类药物。“常备的还是一些感冒药、止疼药，像百服宁等等。同时还有一些创可贴。头孢一定要在一定的条件下才能使用，一感冒就用头孢的做法显然不行。”而省中医院呼吸科史锁芳主任医师家中的“小药箱”也和林勇如出一辙。同时史锁芳还建议，适当的中药治疗也是不错的选择。(记者 杨甜子)

HuXiKe doctor's home will prepare what drugs？Lin yong told reporters，Your home will not prepare cephalosporin drugs。“Stock or some cold medicine、Painkillers weren，Like bufferin and so on。And there is some band-aid。Cephalosporins must be in certain conditions to use，Catch a cold, with the practice of cefazolin apparently not。”And HuXiKe ShiSuo fang, director of the provincial hospital doctors of the home“Small medicine”Lin yong also and prosperity。At the same time ShiSuo fang also suggested，Appropriate treatment of traditional Chinese medicine also is right choice。(Reporter Yang sweet son)