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Doctors aren't only handing out too many antibiotics, they also are frequently prescribing the wrong ones, researchers and public-health officials say.
研究人員和公共衛(wèi)生官員說，醫(yī)生不僅濫開抗生素，而且所開抗生素經(jīng)常是藥不對癥。
Recent studies have shown that doctors are overprescribing broad-spectrum antibiotics, sometimes called the big guns, that kill a wide swath of both good and bad bacteria in the body. Instead, narrow-spectrum antibiotics, like penicillin, amoxicillin and cephalexin, can usually clear up many infections, while targeting a smaller number of bacteria.
近期的研究顯示，醫(yī)生在處方中過度使用廣譜抗生素。這些抗生素有時被稱為“重機槍”，可殺死人體內(nèi)一大批有益和不良細菌。相反，像青霉素、阿莫西林和頭孢氨 等窄譜抗生素則通常可在瞄準(zhǔn)少量細菌的情況下，治愈很多感染類疾病。
Professional organizations, including the American Academy of Pediatrics, and public-health groups such as the Centers for Disease Control and Prevention are pushing doctors to limit the use of broad-spectrum antibiotics. Among the most common broad-spectrum antibiotics are ciprofloxacin and levofloxacin-a class of drugs known as fluoroquinolones-and azithromycin, which is sold by one drug maker under the brand name Zithromax, or Z-Pak.
包括美國兒科學(xué)會(American Academy of Pediatrics)在內(nèi)的專業(yè)組織以及疾病預(yù)防與控制中心(Centers for Disease Control and Prevention)等公共衛(wèi)生組織目前均敦促醫(yī)生限制使用廣譜抗生素。廣譜抗生素中，最常見的是環(huán)丙沙星和左氧氟沙星（被稱為氟喳諾酮類藥物）以及阿奇霉素（某制藥公司以希舒美(Zithromax)品牌銷售）。
Overuse of antibiotics, and prescribing broad-spectrum drugs when they aren't needed, can cause a range of problems. It can make the drugs less effective against the bacteria they are intended to treat by fostering the growth of antibiotic-resistant infections. And it can wipe out the body's good bacteria, which help digest food, produce vitamins and protect from infections, among other functions.
在不必要的情況下，過量使用抗生素和開廣譜藥物可引發(fā)一系列問題。這樣做不僅會促進抗藥性感染不斷擴大，使抗生素在對抗本該對抗的細菌時藥效減少，而且會清除體內(nèi)的有益細菌。這些有益菌可幫助消化食物、產(chǎn)生維生素并保護人體免受感染侵襲等。
In a July study published in the Journal of Antimicrobial Chemotherapy, researchers from the University of Utah and the CDC found that 60% of the time physicians prescribe antibiotics, they choose broad-spectrum ones. 'There is overuse of broad-spectrum antibiotics both in situations where a narrower alternative would be appropriate and in situations where no therapy is indicated at all,' said Adam Hersh, assistant professor of pediatrics at University of Utah and a study author.
《抗菌化學(xué)療法雜志》(Journal of Antimicrobial Chemotherapy)今年7月刊登了一篇研究論文，其中猶他大學(xué)(University of Utah)和疾病預(yù)防與控制中心的研究人員發(fā)現(xiàn)，醫(yī)師開抗生素時，60%會選擇廣譜抗生素。猶他大學(xué)兒科助理教授、論文作者之一赫什(Adam Hersh)說，濫用抗生素的做法存在于兩種情況下，一種是用窄譜抗生素也可獲得不錯的療效，一種是完全不需治療。
The study, which relied on a public database with information on nearly 240,000 visits to doctor's offices and emergency departments, said illnesses for which doctors choose the stronger antibiotics include skin infections, urinary-tract infections and respiratory problems.
這篇研究論文說，醫(yī)生選擇使用藥效更強的抗生素對抗的疾病包括皮膚感染、尿路感染和呼吸系統(tǒng)疾病等。該研究以一個公共數(shù)據(jù)庫為基礎(chǔ)，該數(shù)據(jù)庫有關(guān)于近24萬人次到門診和急診室看病的信息。
A similar study of children, published in the journal Pediatrics in 2011, found that when antibiotics were prescribed they were broad-spectrum 50% of the time, mainly for respiratory conditions.
2011年刊登于雜志《兒科學(xué)》(Pediatrics)上的一篇有關(guān)兒童的類似研究發(fā)現(xiàn)，醫(yī)生在開抗生素時，50%開的都是廣譜抗生素，主要用于治療呼吸疾病。
Both studies also found that about 25% of the time antibiotics were being prescribed for conditions in which they have no use, such as viral infections.
這兩份研究均認(rèn)為，醫(yī)生開抗生素時，約25%開給了病毒性感染等疾病，而抗生素對這些疾病毫無幫助。
'This is upward of 30, 40 million prescriptions a year. And on top of it, these are conditions where antibiotics aren't justified-coughs, colds, bronchitis-and the majority of the antibiotics prescribed are the broad-spectrum antibiotics,' says Dr. Hersh, also a co-author of the Pediatrics study.
《兒科學(xué)》雜志上這篇論文的共同作者之一赫什說，每年醫(yī)生會開超過3,000萬到4,000萬份處方，最重要的是有些疾病本沒有開抗生素的正當(dāng)理由，如咳嗽、感冒和支氣管炎等，而開出的大多數(shù)抗生素又是廣譜抗生素。
When doctors don't know exactly what type of bacteria is causing an infection they may prescribe a broad-spectrum antibiotic. Ordering up a test to isolate the source of the bacteria can take a day or two to get results. Waiting can risk the infection spreading. Patients also may be in discomfort and not willing to wait.
當(dāng)醫(yī)生不確定是哪種細菌造成感染時，他們可能會開廣譜抗生素。若為隔離細菌源讓病人進行檢測，可能需要一兩天才能拿到結(jié)果。等待期間，感染可能會擴散。病人也可能會覺得身體不舒服，不愿等這么長時間。
Experts say broad-spectrum antibiotics are best used for more severe conditions, such as when a child or adult is in the hospital or has already had multiple courses of antibiotics that didn't work. Someone at risk for infection with resistant bacteria because of repetitive or prolonged antibiotic exposure, such as recurrent ear infections, might also fare better with a broad-spectrum drug.
專家說，廣譜抗生素最好是用于較為嚴(yán)重的情況，比如幼兒或成人住院或已經(jīng)使用多個療程的抗生素但未能見效。因重復(fù)或長期使用抗生素的情況而有抗藥菌感染風(fēng)險者使用廣譜抗生素可能也更好。耳部感染反復(fù)發(fā)作的病人就屬于這種情況。
