美国研究人员日前在《儿科》杂志上发表报告称，他们的分析结果显示，美国儿科大夫每年多开出1000多万剂非必需的抗生素，这也是危险的多重耐药细菌在一些地区蔓延的原因之一。
研究人员对2006年至2008年间近6.5万人次的18岁以下门诊患者的数据进行分析后发现，美国儿科大夫为其中五分之一的患者开出了抗生素处方药。在一些细菌感染的情况下，服用抗生素很有必要。
不过研究人员发现，约有四分之一的抗生素开给了很可能或根本不需要抗生素的儿童，例如流感、过敏患者等。他们估算后认为，这相当于每年多开出1000多万剂不但无益反而有害的抗生素。
领导研究的犹他大学助理教授亚当·赫什说，很多情况下，医生们在患者病情尚不完全清楚的情况下为安全起见开具了抗生素，而且开具的多半是广谱抗生素，不但能杀死有害细菌，体内有益的细菌也会一并被消灭。而滥用抗生素增加了儿童今后感染更危险的多重耐药细菌的风险。
赫什认为，儿科大夫们在患儿病情仍不十分清楚的情况下，不应贸然开具抗生素，在条件许可的情况下，应该对病情观察一两天再作决定。
近年来，美国儿科超级细菌MRSA（耐甲氧西林金黄色葡萄球菌）感染病例持续增加，引起医学人员关注。他们呼吁谨慎使用抗生素，以免增强病菌的耐药性。
金黄色葡萄球菌是很常见的病菌，感染后会使人皮肤上长疮和丘疹，严重时可引起肺炎或血液感染。对这种病菌引起的感染常用青霉素类抗生素甲氧西林治疗，大部分情况下很有效。但有些金黄色葡萄球菌菌株对甲氧西林产生了耐药性，这样的病菌能引起深度感染，导致严重甚至是致命的炎症，有“超级细菌”之称。滥用抗生素被认为是超级细菌蔓延的重要原因。（生物探索）
相关英文论文摘要：
National Ambulatory Antibiotic Prescribing Patterns for Pediatric Urinary Tract Infection, 1998–2007
OBJECTIVE: The goal of this study was to investigate patterns of ambulatory antibiotic use and to identify factors associated with broad-spectrum antibiotic prescribing for pediatric urinary tract infections (UTIs).
METHODS: We examined antibiotics prescribed for UTIs for children aged younger than 18 years from 1998 to 2007 using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Amoxicillin-clavulanate, quinolones, macrolides, and second- and third-generation cephalosporins were classified as broad-spectrum antibiotics. We evaluated trends in broad-spectrum antibiotic prescribing patterns and performed multivariable logistic regression to identify factors associated with broad-spectrum antibiotic use.
RESULTS: Antibiotics were prescribed for 70% of pediatric UTI visits. Trimethoprim-sulfamethoxazole was the most commonly prescribed antibiotic (49% of visits). Broad-spectrum antibiotics were prescribed one third of the time. There was no increase in overall use of broad-spectrum antibiotics (P = .67); however, third-generation cephalosporin use doubled from 12% to 25% (P = .02). Children younger than 2 years old (odds ratio: 6.4 [95% confidence interval: 2.2–18.7, compared with children 13–17 years old]), females (odds ratio: 3.6 [95% confidence interval: 1.6–8.5]), and temperature ≥100.4°F (odds ratio: 2.9 [95% confidence interval: 1.0–8.6]) were independent predictors of broad-spectrum antibiotic prescribing. Race, physician specialty, region, and insurance status were not associated with antibiotic selection.
CONCLUSIONS: Ambulatory care physicians commonly prescribe broad-spectrum antibiotics for the treatment of pediatric UTIs, especially for febrile infants in whom complicated infections are more likely. The doubling in use of third-generation cephalosporins suggests that opportunities exist to promote more judicious antibiotic prescribing because most pediatric UTIs are susceptible to narrower alternatives.
英文论文链接：https://pediatrics.aappublications.org/content/127/6/1027
