(新闻)英国治小病禁用抗生素

英国国家医疗服务系统所属“全国卫生与临床学会”出台新规,对抗生素药品的使用提出更严格规定。

英国《每日电讯报》23日报道,根据新规,英国医生将不得给患有轻微耳道感染、咽喉痛、扁桃体发炎、感冒、咳嗽、鼻窦炎、支气管炎的病人开具抗生素类药品处方,取而代之的是建议患者回家休息或服用止痛片。

新规

全国卫生与临床学会制定的用药新规指出,如果不是处于特别危急状况,医生一般不得给上述病人开抗生素类药品,因为这类药品不但“对缓解症状没什么帮助,还会产生不小的副作用”。

规定说,如果一段时间后,病人病情没有好转甚至出现恶化,医生才能考虑给病人提供抗生素类药品。假如病人不愿意使用这样的诊疗程序,医生也可以先开好抗生素处方,但要求病人在至少一周之后,有需要的情况下才去购买。

根据新规,医生可以为2岁以下双耳感染或耳朵流脓的患儿开抗生素药品;那些扁桃体炎并发其他疾病的患者也可服用抗生素。

此外,如果患者有出现其他并发症的危险,或患有心、肺、肾、肝等脏器疾病或免疫系统疾病,医生也可为他们开抗生素药品,并进行进一步检查。

新规定还对65岁和80岁以上病人如何使用抗生素分别作出说明。

滥用

全国卫生与临床学会副执行官吉莲·伦说,这是英国在抗生素应用方面的首个指导原则。医务人员将通过判断患者需要以控制抗生素的使用量。

《每日电讯报》说,推出新规之前,英国的家庭医生通常会建议普通呼吸道感染病人服用抗生素。仅在去年,英国医生就开出了3800万张抗生素处方。英国人服用抗生素的花费高达1.75亿英镑(约合3.48亿美元)。其中三分之二的抗生素处方针对呼吸道感染。

英国卫生部首席医疗官利亚姆·唐纳森说,滥用抗生素容易使病菌产生抗药性。有“超级病菌”之称的耐甲氧西林金黄色葡萄球菌近期在英国各医院的蔓延就是滥用抗生素的结果。

今年年初,英国卫生大臣艾伦·约翰逊曾在全国范围内开展宣传活动,呼吁民众不要在咳嗽或感冒时服用抗生素,因为它对这两种病几乎无效。

顾虑

报道说,一些医生担心,如果拒绝给病人开抗生素处方,可能会招致病人的愤怒。因为在许多人脑海中,抗生素能帮助治好咽喉疼痛等疾病的想法根深蒂固。

英国皇家全科医师学院教授史蒂夫·菲尔德教授说,医生说服患者暂时不使用抗生素并非易事,服用抗生素在某些人看来是必不可少的。因为轻微的感染不管吃不吃药本身就可以自愈,而吃了药的人们就会以为这是抗生素的功效。

不过,专家说,控制抗生素使用的规定试行一段时间以来收效良好,绝大部分患者听从医生建议,最终没有使用抗生素。

信息来源:慧聪

Doctors to be banned from dishing out antibiotics

for sore throats and colds

By Daniel Martin
Last updated at 9:02 PM on 23rd July 2008

doctor with patient

Doctors are to be told not to hand out antibiotics for coughs and colds under new guidelines. (Posed by models)

Doctors will be told not to hand out antibiotics for coughs, sore throats and colds under guidelines to be unveiled today.

GPs have been accused of wasting more than £100million on the drugs every year for patients with respiratory tract infections.

Rationing watchdog the National Institute for Clinical Excellence said today that the vast majority of cases would clear up on their own.

Adults should simply ‘take a rest’ while children should be offered ‘love and attention’.

And NICE warned that putting patients on antibiotics placed them at needless risk of side effects such as nausea, diarrhoea and vomiting.

Experts also believe that overuse of antibiotics could be a major factor behind the spread of superbugs such as MRSA because it prompts harmful bacteria to develop resistance, and could make it harder to treat serious conditions in the future.

In 2007, GPs wrote 38 prescriptions for antibiotics, costing the Health Service £175million.

NICE said 60 per cent of these were for patients with respiratory tract infections meaning around £105million was wasted.

Colds are caused by viruses, which means that antibiotics, which work only against bacteria, are useless.

Earlier this year, Britain’s chief medical officer Sir Liam Donaldson said that between 25 and 35 per cent of treatments were unnecessary and did not cure common infections.

Around a quarter of the population visits the GP every year because of a respiratory tract infection.

Professor Paul Little, who drew up the guidelines, said: ‘Management of respiratory tract infections in the past concentrated on advising prompt antibiotic treatment.

‘However, as rates of major complications are much less common in modern developed countries, so the evidence of symptomatic benefit should be strong to justify prescribing antibiotics so that we are not needlessly exposing patients to side effects.’

The NICE guidance said GPs should reassure patients that antibiotics are not needed immediately because they will make little difference to symptoms and may have side effects.

They should be told to take simple cough medicines and pain killers.

However, if symptoms persist or get worse, antibiotics may then be prescribed.

For some patients, such as children younger than two, the elderly and those with complications or pre-existing conditions, antibiotics should still be handed out immediately, the guidance says.

Dr Steve Field, chairman of the Royal College of GPs, said many doctors were already following these ideas and were putting up posters in their surgeries warning patients they may not be prescribed antibiotics.

‘It is very difficult when doctors want to please patients but the big message is that patients should no longer expect to be given antibiotics in the majority of cases,’ he said.

‘Hopefully it will mean patients will learn to manage their care at home rather than always relying on doctors.’

  • Health Service trusts are being forced to build polyclinics even when they tell ministers it could jeopardise patient care.

E-mails obtained under freedom of information reveal the Department of Health is overruling strong objections from senior experts.

The polyclinics will place family doctors alongside services such as minor surgery and physiotherapy.

Doctors have warned they could force local GP surgeries to close, and more than a million patients signed petitions against them.

The e-mails obtained by Pulse magazine reveal that Herefordshire primary care trust, for example, said polyclinics were ‘neither affordable nor value for money’.

But it has been forced to back down, despite ministers’ claims the changes would be ‘locally led’.

Tory health spokesman Mark Simmonds said: ‘Labour have claimed that they are not imposing polyclinics on local people, but these e-mails expose that lie for what it is.’

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