Will reduction of antibiotic use reduce antibiotic resistance? The pneumococcus paradigm
Will reduction of antibiotic use reduce antibiotic resistance? The pneumococcus paradigm
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DOI：
10.1097/01.inf.0000239266.20642.26
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发表时间：
2006-10-01
影响因子：
3.6
通讯作者：
Greenberg, David
中科院分区：
文献类型：
--
作者：
Dagan, Ron;Barkai, Galia;Greenberg, David
一般的社区获得性呼吸道感染，以及由沙门氏菌引起的感染。尤其是肺炎，是在幼儿中开抗微生物药的主要原因。滥用抗生素药物很常见。这是减少抗生素使用倡议的基础。然而，由于没有考虑到并非所有抗生素在促进耐药性方面的作用都是相似的，因此导致了不断出现的耐药性。本文综述了小儿抗生素处方的趋势及其与呼吸道链球菌耐药性的关系。沿着理论上的考虑和研究证据，导致得出结论，在抗生素中，最少的耐药促进药物的肺炎链球菌在儿童将进行审查。肺炎克雷伯菌的最佳耐药药物是阿莫西林（+/-克拉维霉素），而口服头孢菌素和阿奇霉素在社区的个体人群中表现出更高的耐药促进潜力。尽管抗生素在促进耐药性方面的潜力不同，但所有抗生素都能促进耐药性。
Community-acquired respiratory infections in general, and those caused by S. pneumoniae in particular, are the main reason for prescribing antimicrobials in young children. Antibiotic drug abuse is common. This is the basis for the initiative for the reduction in antibiotic use. However, failure to consider that not all antibiotics are similar in their effect on promotion of resistance has led to continuous emerging resistance. In the present article, the trends in prescribing antibiotics in young children and their interrelation with antibiotic resistance among clinical respiratory isolates of S. pneumoniae in children will be reviewed, along with theoretical considerations and research evidence that led to concluding that among antibiotics, the least resistance-promoting drug for S. pneumoniae is amoxicillin (+/- clavulanate), whereas oral cephalosporins and azithromycin demonstrate a higher resistance-promotion potential in the individual population in the community. Although antibiotics differ in their resistant-promotion potential, all still do promote resistance.