我国抗菌药物滥用 阻击战需医患携手 Our country antibacterial drug abuse blocking action should be doctor-patient hand in hand

抗菌药在国外临床使用率不超过30%，国内三级医院保守估计达60%~70%，二级医院甚至超过80% Antibacterial in foreign clinical utilization rate no more than 30%,Domestic tertiary hospital conservative estimate that up to 60% ~ 70%,Secondary hospital even more than 80%

　　刚刚过去的9月是“全国安全用药月”，主题就是“谨慎使用抗生素”。抗生素滥用现象如今是否已得到改善？国家食品药品监督管理局前不久发布了《2012公众安全用药现状调查报告》。报告显示，近四成居民表示家中常备抗生素类药品，23.9%的居民感冒后选择使用抗生素，仅40.1%的居民会在服药前认真阅读药品说明书上的不良反应及注意事项。以抗生素为主的抗菌药物滥用问题依然严重。

Just the past September is"The national security on drugs",Theme is"Careful use of antibiotics".Antibiotics abuse phenomenon now is improved?State food and drug administration recently released[2012 public safety use present situation investigation report].The report shows that,Nearly forty percent of residents say home permanent antibiotic drugs,23.9% of the residents a cold choose to use antibiotics,Only 40.1% of the residents will read it carefully before taking the medicine in the drug instruction adverse reactions and the matters needing attention.Give priority to with antibiotics antibacterial drug abuse problem is serious.

　　根据世界卫生组织统计，抗菌药在国外的临床使用率不超过30%，而在国内三级医院保守估计要达到60%~70%，二级医院甚至超过80%。卫生部全国细菌耐药监测结果也显示，我国住院患者中，抗生素的使用率高达70%，其中外科患者几乎人人都用抗生素，比例高达97%。

According to the world health organisation,Antibacterial in foreign clinical utilization rate no more than 30%,And in the domestic tertiary hospital conservative estimate to reach 60% ~ 70%,Secondary hospital even more than 80%.The ministry of health the bacterial drug resistance monitoring result also shows,Our country in hospitalized patients,Antibiotic utilization rate as high as 70%,The surgery patient almost everyone with antibiotics,Rates as high as 97%.

　　滥用抗菌药的一个严重后果，就是会诱发细菌耐药，最终可能导致“无药可用”。一旦细菌产生耐药性的速度远远快于新药开发的速度，就会让人类重新面临很多感染性疾病的威胁。根据国内抗生素监测机构的调查，较常见的肺炎克雷伯菌，对目前被认为抗菌活性最强的碳青霉烯类抗生素“泰能”和“美平”的耐药率，从2005年的1%左右上升到现在的9.5%。10年前不动杆菌最多只有3%是耐药的，现在耐药率超过50%。如果这种情况再发展下去，很多细菌感染性疾病将无药可用，患者只能等待死亡。

Abuse of antibacterial a serious consequences,Is will induce bacterial drug resistance,Could eventually lead to"No medicine can be used".Once the bacteria produce resistance speed is far faster than the speed of development of new medicine,Can let the human to face the threat of many infectious diseases.According to the investigation of domestic antibiotic monitoring mechanism,The more common pneumonia crayresearch bacteria,The present is considered the strongest antimicrobial activity of carbon blue mould olefinic antibiotic"Thai can"and"Beautiful flat"resistant,From 2005 years of 1% up to 9.5% now.10 years ago most of acinetobacter only 3% is resistance,Now more than 50% respectively.If this kind of circumstance to develop,A lot of bacterial infectious diseases will have no medicine can be used,Patients can only waiting for death.

　　抗菌药滥用还会造成医疗费用的无谓增长和病患的损伤。因为抗菌药在杀菌的同时，也会造成人体损害。据中华医学会行为医学分会主任委员杨志寅披露的数据，我国内地每年约有20万人死于药物不良反应，其中滥用抗生素造成的死亡占40%。目前住院患者中抗生素使用率高达70%，约80%以上属于滥用抗生素。

Drug abuse still can cause medical cost of patients meaningless growth and damage.Because antibacterial sterilization in at the same time,Also can cause human body damage.According to the Chinese medical association chairman of behavioral medicine branch YangZhiYin disclosure of data,In mainland China each year about 200000 people died from accidental drug adverse reaction,The abuse of antibiotics cause death accounted for 40%.At present in hospitalized patients with antibiotic utilization rate as high as 70%,About 80% belong to the abuse of antibiotics.

　　据新华网报道，卫生部医政司副司长赵明钢曾表示，我国个别医疗机构及医务人员确实存在抗菌药物不合理应用的现象，其中有六方面主要原因：一是目前基层医务人员对抗菌药物的了解还有待进一步提高；二是有的医务人员为了避免医患纠纷，按患者及其家属的要求使用抗菌药物；三是部分药品生产企业营销行为不规范，加之极个别医务人员存在着医德医风问题，导致抗生素使用不合理；四是公众合理使用抗菌药物的意识还比较薄弱，有些群众身体一不舒服就会想到吃一些抗生素，有的患者会到医院去开，还有许多患者会直接到药店购买；五是有一些深层次的问题，如公立医院的补偿机制不完善，“以药补医”的机制仍然在医院里发挥着很重要的作用；六是多种因素导致患者在诊疗前对抗菌药物敏感性降低，医务人员为了获得良好的治疗效果，在临床治疗过程中不得不提高抗菌药物使用量和应用强度。

According to xinhua,The ministry of health YiZhengSi deputy director general ZhaoMingGang has said,Our country individual medical institutions and medical workers do exist antibacterial drugs is not reasonable application of the phenomenon,There are six main reason:One is the grassroots medical staff the antimicrobial understand remains to be further improve;The second is some medical staff in order to avoid medical disputes,According to the requirements of the patients and their families use of antimicrobial agents;Part three is a pharmaceutical production enterprise marketing behavior is not standard,Together with the extremely individual medical staff exist problems of medical ethics,Lead to antibiotic usage is not reasonable;The fourth is the public in the rational use of antimicrobial agents consciousness is relatively weak,Some people a body uncomfortable will think of eating some antibiotics,Some patients will open to the hospital,There are many patients will directly to the drugstore is bought;Five is some deep problems,Such as public hospital compensation mechanism is not perfect,"In medicine for medical"The mechanism is still in the hospital plays a very important role;Six is a variety of factors in diagnosis and treatment of patients with reduced susceptibility before antimicrobial drugs,Medical staff in order to obtain good treatment effect,In the clinical treatment process to increase the antibacterial drug usage and application of strength.

　　“我们一方面加强对医务人员的医德教育，另一方面要加大对违规违纪人员的惩治力度。”赵明钢说。

"On one hand we strengthen the medical staff of medical ethics education,On the other hand we should strengthen the discipline of personnel punishment dynamics."ZhaoMingGang said.

　　事实上，对于滥用抗菌药的问题，我国政府早已开始重视。从上世纪90年代末我们就开始了强化处方药和非处方药的药品流通管理。2004年，卫生部颁布《抗菌药物临床应用指导原则》。2005年，为掌握全国抗菌药物临床应用和细菌耐药形势，我国建立了“抗菌药物临床应用监测网”和“细菌耐药监测网”。2011年，卫生部在全国开展了抗菌药物临床应用专项整治，对医疗机构抗菌药物品种数、住院患者抗菌药物使用率等相关指标提出了具体量化限定要求。

In fact,For the problem of drug abuse,The Chinese government had already started to pay attention to.From the 1990 s we began to the reinforcement of prescription and over-the-counter drugs circulation management.In 2004,,Promulgated by the ministry of health[Antibacterial drug clinical application guiding principle].In 2005,,In order to know the clinical application of antimicrobial and drug resistance of bacteria situation,Established in our country"Antibacterial drug clinical application of monitoring network"and"Bacterial resistance monitoring network".In 2011,,The ministry of health in the national carried out antibacterial drug clinical application special improvement,For medical institutions antibacterial items species/Patients in hospital antimicrobial usage and other related index put forward specific quantitative limit requirements.

　　今年8月1日起，《抗菌药物临床应用管理办法》正式实施，卫生部在其官网称，《办法》是对过去10余年来抗菌药物临床应用管理实践经验的提炼和固化，其发布标志着我国抗菌药物临床应用管理进入法制化、制度化轨道，为逐步建立抗菌药物临床应用管理长效机制奠定了基础。该《办法》被称为“史上最严限抗令”，也标志着我国抗菌药物滥用阻击战已进入攻坚阶段，这更需要全社会的共同参与。

August 1st,[Measures for the administration of antimicrobial drugs for clinical use]Formal implementation,The ministry of health said on its website,[way]For the past 10 years is antibacterial drug clinical application management experience in the practice of the refining and curing,Issued by the China marked the antimicrobial clinical application management into the legal system/Institutionalization orbit,To gradually establish antibacterial drug clinical application management laid the foundation for long-term mechanism.this[way]called"History the most strict limit resistance to make",Our country also marks the antibacterial drug abuse blocking action has entered the stage of storming fortifications,The more need of the whole society to participate in together.

　　据《中国科学报》报道，由于我国医药知识普及程度不够，国民医药知识相对匮乏，易受药商促销广告宣传的影响，对处方药和非处方药的概念不清。加上去医院找大夫开药，费时费钱，不如直接到药店买药、诊所输液方便，这就使抗菌药滥用有了市场。专家建议，应加强对公众合理使用抗菌药物的宣传教育，纠正公众的错误用药观念、用药行为和用药习惯。如果缺乏公众参与，仅靠卫生行政部门和医疗机构单兵独进，战果只能是暂时、局部、有限的。

According to[China's proceedings]reports,Because our country medicine knowledge popularity is not enough,The national medicine knowledge is relatively lack,Vulnerable druggist promotional advertisement publicity of influence,For prescription and non-prescription drugs concept is not clear.And go to a hospital looking for the doctor to prescribe medicine,Time-consuming costly,As directly to the drug store to buy medicine/Clinic infusion convenient,This makes antibacterial abuse have the market.Experts suggest,To the public should be strengthened in the rational use of antimicrobial agents propaganda education,Correct public wrong medication concept/Use behavior and custom.If the lack of public participation,Only by the administrative department of public health and medical institutions individual scoring,Victory can only be temporary/local/limited.

　　“要减少抗菌药物的不合理使用，需要医患双方的共同努力。”浙江大学医学院附属邵逸夫医院感染科主任俞云松也认为，老百姓要抛弃对抗菌药物的错误观念，提高科学用药意识，生病要到医院及时检查，遵照医嘱用药。“减少抗菌药物不合理使用，关键是要提高公众意识。有关部门也应继续加大对抗菌药物科学用药的宣传力度。让大家认识到，少用药是好事，少用抗菌药物更是好事。”(韩妹)

"To reduce the unreasonable use of antibacterial drugs,Need doctor-patient concerted efforts of both sides."Zhejiang university school of medicine have affiliated hospital infection of director of division of YuYunSong also think,Common people want to abandon the antimicrobial wrong idea,Improve science drug consciousness,Ill will in time to the hospital inspection,Medicine follow the doctor's order."Reduce the unreasonable use of antimicrobial agents,The key is to raise public awareness.The relevant departments should also continue to strengthen the scientific and medical treatment of antimicrobial agents the propaganda.Let us realize the,Less medication is a good thing,Less use of antimicrobial agents is good."(HanMei)