抗生素的安全使用(英文)dobugsneeddrugs课件

DoBugsNeedDrugs?ACommunityProgramforWiseUseofAntibioticsDoBugsNeedDrugs?ACommunity1

AntibioticsMostsignificantdiscoveryofmodernmedicineSavemillionsoflives AntibioticsMostsignificantd2CausedbyoveruseandmisuseofantibioticsLimitseffectivenessofantibioticsPatientswithresistantinfectionscannotbetreatedAntibioticResistanceCausedbyoveruseandmisuseo375%ofantibioticsprescribedforrespiratorytractinfections50%ofantibioticprescriptionsareinappropriateMostrespiratorytractinfectionsarecausedbyvirusesAntibioticsdonotworkagainstvirusesAntibioticsinthe

Community75%ofantibioticsprescribed4Canadiansurvey,NIPA,200253%ofadultsbelieveantibioticsareeffectiveagainstvirusesMisconceptionsCanadiansurvey,NIPA,2002Mis5HealthCanada,CCAR,1997Decreaseantibioticprescriptionsforrespiratorytractinfectionsby25%National

MandateHealthCanada,CCAR,1997Natio6Healthcareprofessionals,public,students,childcarecentres,seniorsStartedOctober1998MultistakeholderprogramACommunityProgramforWiseUse

ofAntibioticsHealthcareprofessionals,publ7Washyourhands! Handwashingisthebestwaytostopthespreadofinfections.Notallbugsarecreatedequal. Antibioticsworkagainstbacteria,

butnotagainstviruses.Useantibioticswisely. Bacteriacanbecomeresistanttoantibiotics.KeyMessagesWashyourhands!KeyMessages8HandwashingHandwashing9 Handwashing80%ofcommoninfectionsspreadbyhandsMosteffectivewaytopreventthespreadofrespiratorytractinfections Handwashing80%ofcommoninfe10GoodBacteriaGoodbacterialiveontheskinandinthemouthandintestinesDonotcausediseaseNoteasilyremovedbyhandwashingProtectagainstdisease-causingbacteriaandvirusesGoodBacteriaGoodbacterialiv11BadGermsUsuallysurvivelessthan24hoursEasilyremovedbyhandwashingCanbeeitherbacteriaorvirusesCausediseaseBadGermsUsuallysurviveless12Howdirtyarethings?

UniversityofArizonastudyTucson,Chicago,SanFrancisco

Contamination(%)Playground 44Busrails 35PublicRestrooms 25Pens(shared) 16VendingMachines 14Publicphones* 13*homephonesmorecontaminatedHowdirtyarethings?13Howeasyisittotransmitgerms?10millionE.coli0157.H7Pattingcontaminatedgroundbeef1,000–100,000bacteriatohandsTouchingpatientshoulderMeasuringbloodpressureHoweasyisittotransmitger14TelephoneandobservationalhandwashingsurveysSeptember2005/6000+people91%saytheywashtheirhands83%actuallydo90%women/75%menDopeoplereallywash?AmericanSocietyforMicrobiologyTelephoneandobservationalha15Doesitwork?RyanM,HealthNavalResearchCenter,SanDiegoRecruitsorderedtowashhandsatleast5times/day45%reductioninrespiratoryillnessLeeM,CanadianJournalofInfection,TorontoNursingstudentswashedhandsatleast7times/dayReducednumberofinfections/coldsDoesitwork?RyanM,HealthNa16KarachiStudy-2005SquattersettlementsThreegroups:nosoapplainsoapantimicrobialsoapGroupsreceivingsoap:50%reductioninpneumonia53%reductionindiarrhea34%reductioninimpetigoNobenefitinusingantibacterialsoapKarachiStudy-2005Squatterset17Beforemeals/foodpreparationAfterusingthetoilet/helpingachildusethetoiletBeforeandafterchangingdiapersAfterblowingnose/helpingachildwitharunnynoseAfterplayorhandlingsharedobjectsBeforeinserting/removingcontactlensesBeforeflossingyourteethWhentoWashHandsBeforemeals/foodpreparatio18WetyourhandsApplysoapRubhandstogetherfor20seconds SingTwinkle,TwinkleSongRinsefor10secondsDrywithatowelUsetoweltoturnofftapsandopenthedoorHowtoWashHandsWetyourhandsHowtoWashHand19SoapDoesnothaveantibioticsRemovesdirtandgreasethatattractbadgermsDoesnotpromoteantibacterialresistanceUseplainsoapSoapDoesnothaveantibioticsU20AntibacterialsoappromotesantibioticresistanceAntibacterialsoapaddsantibioticstotheenviromentNomoreeffectivethanplainsoapSoapAntibacterialsoapnotrecommendedAntibacterialsoappromotesan21HandDryingRemoves42%moregermsthanwashingaloneUsecleantowelsAvoidsharingtowelsHotairdryerspromotebacterialgrowthbecausehandsareleftwarmandmoistHandDryingRemoves42%morege22

HandwashingBestwaytostopthespreadofrespiratorytractinfections HandwashingBestwaytostopt23TMAlcohol-basedgels(≥60%alcohol)DonotcauseantibioticresistanceKillmanybacteriaandvirusesNoteffectiveagainstmanygermsthatcausediarrheaShouldnotreplacesoapandwater.Notneededinthehome.AlcoholhandrubsTMAlcohol-basedgels(≥60%al24NotAllBugsAre

CreatedEqualNotAllBugsAre

CreatedEqual25NotAllBugsAre

CreatedEqualBothvirusesandbacteriacauserespiratorytractinfectionsMostrespiratorytractinfectionsarecausedbyvirusesNotAllBugsAre

CreatedEqual26ViralInfectionsMostrespiratorytractinfectionsarecausedbyvirusesViralinfectionsmakeyoufeelsickalloveryourbodyColdsandflu,andmostsorethroats,coughsandsinusinfectionsarecausedbyvirusesAntibioticsDONOTworkagainstvirusesViralInfectionsMostrespirato27LesscommonthanviralinfectionsDonotspreadaseasilyfromonepersontoanotherUsuallyaffectonlyonepartofthebodyPneumoniaandStrepthroatarecausedbybacteriaAntibioticsDOworkagainstbacteriaBacterial

InfectionsLesscommonthanviralinfecti28Antibiotic

ResistanceAntibiotic

Resistance29Antibiotic

ResistanceAntibioticskillmostbacteriabutsomeareabletosurviveSurvivingbacteriahave“antibioticresistance”AntibioticresistantbacteriacannotbekilledbythatantibioticAntibiotic

ResistanceAntibioti30Antibiotic

ResistanceTakingantibioticswhentheyarenotneededmakesyourgoodbacteriaresistantAntibioticresistancecanbetransferredfromonebacteriumtoanother,includingbadbacteriathatcausediseaseAntibiotic

ResistanceTakingan31Antibiotic

ResistanceAntibioticswillnotworkagainstbacteriawithantibioticresistancePeoplecandiefromantibioticresistantinfectionsAntibiotic

ResistanceAntibioti32Antibiotic

ResistanceBacteriahaveantibioticresistancewhentheycannotbekilledbyanantibiotic.Remember,itisthebacteriathatareresistant

NOTYOU!Antibiotic

ResistanceBacteria33

FeverHelpsthebodyfightinfectionOccurswithmostrespiratorytractinfectionsOccurswithbothviralandbacterialinfections FeverHelpsthebodyfightinf34Cold/RunnyNoseColdsarecausedbyvirusesMostcoldsareassociatedwithasorethroatoracoughFluidfromthenosebecomesyellow/greenafter2-3days ThisdoesnotmeanitisabacterialinfectionCold/RunnyNoseColdsarecau35

InfluenzaInfluenzaiscausedbyavirusPreventionofinfluenza:InfluenzavaccineFrequenthandwashingStayawayfromschoolorwork InfluenzaInfluenzaiscaused36SoreThroatMostsorethroatsareduetovirusesOccasionallyasorethroatmaybeduetoStreptococcusbacteriaTheonlywaytodiagnoseStrepthroatiswithathroatswab.SoreThroatMostsorethroatsa37EarAche70-80%ofearinfectionsgetbetterwithoutantibioticsInchildrenover2yearsofage-useacetaminophenfor48-72hoursHandwashingisthebestpreventionforearinfectionssincemostearinfectionsoccurafteracoldEarAche70-80%ofearinfectio38SinusitisViralsinusitisisupto200timesmorecommonthanbacterialsinusitisYellow/greennasaldischargelastingmorethan10daysmayindicatebacterialsinusitisSinusitisViralsinusitisisup39

CoughMostcoughsinadultsandchildrenarecausedbyviralinfectionsCoughisoftenprolongedwithviralinfectionsSometimesacoughmayindicatepneumonia CoughMostcoughsinadultsan40YOUCANMAKEADIFFERENCE!!Promoteandsupportthreekeymessages:Washyourhands!Notallbugsarecreatedequal.Useantibioticswisely.

ACommunityProgram

forWiseUse

ofAntibioticsYOUCANMAKEADIFFERENCE!! A41

UsingthispresentationAvailable:/public/tutorial.htmlToseeslideannotations,goto“View”andselect“Notespage”Ifusingthispresentationpleaseincludethisstatement:DoBugsNeedDrugs?wasdevelopedbyCapitalHealth,TowardsOptimizedPracticeprogramoftheAlbertaMedicalAssociation,AlbertaLungAssociationandUniversityofAlberta. UsingthispresentationAvail42DoBugsNeedDrugs?ACommunityProgramforWiseUseofAntibioticsDoBugsNeedDrugs?ACommunity43

AntibioticsMostsignificantdiscoveryofmodernmedicineSavemillionsoflives AntibioticsMostsignificantd44CausedbyoveruseandmisuseofantibioticsLimitseffectivenessofantibioticsPatientswithresistantinfectionscannotbetreatedAntibioticResistanceCausedbyoveruseandmisuseo4575%ofantibioticsprescribedforrespiratorytractinfections50%ofantibioticprescriptionsareinappropriateMostrespiratorytractinfectionsarecausedbyvirusesAntibioticsdonotworkagainstvirusesAntibioticsinthe

Community75%ofantibioticsprescribed46Canadiansurvey,NIPA,200253%ofadultsbelieveantibioticsareeffectiveagainstvirusesMisconceptionsCanadiansurvey,NIPA,2002Mis47HealthCanada,CCAR,1997Decreaseantibioticprescriptionsforrespiratorytractinfectionsby25%National

MandateHealthCanada,CCAR,1997Natio48Healthcareprofessionals,public,students,childcarecentres,seniorsStartedOctober1998MultistakeholderprogramACommunityProgramforWiseUse

ofAntibioticsHealthcareprofessionals,publ49Washyourhands! Handwashingisthebestwaytostopthespreadofinfections.Notallbugsarecreatedequal. Antibioticsworkagainstbacteria,

butnotagainstviruses.Useantibioticswisely. Bacteriacanbecomeresistanttoantibiotics.KeyMessagesWashyourhands!KeyMessages50HandwashingHandwashing51 Handwashing80%ofcommoninfectionsspreadbyhandsMosteffectivewaytopreventthespreadofrespiratorytractinfections Handwashing80%ofcommoninfe52GoodBacteriaGoodbacterialiveontheskinandinthemouthandintestinesDonotcausediseaseNoteasilyremovedbyhandwashingProtectagainstdisease-causingbacteriaandvirusesGoodBacteriaGoodbacterialiv53BadGermsUsuallysurvivelessthan24hoursEasilyremovedbyhandwashingCanbeeitherbacteriaorvirusesCausediseaseBadGermsUsuallysurviveless54Howdirtyarethings?

UniversityofArizonastudyTucson,Chicago,SanFrancisco

Contamination(%)Playground 44Busrails 35PublicRestrooms 25Pens(shared) 16VendingMachines 14Publicphones* 13*homephonesmorecontaminatedHowdirtyarethings?55Howeasyisittotransmitgerms?10millionE.coli0157.H7Pattingcontaminatedgroundbeef1,000–100,000bacteriatohandsTouchingpatientshoulderMeasuringbloodpressureHoweasyisittotransmitger56TelephoneandobservationalhandwashingsurveysSeptember2005/6000+people91%saytheywashtheirhands83%actuallydo90%women/75%menDopeoplereallywash?AmericanSocietyforMicrobiologyTelephoneandobservationalha57Doesitwork?RyanM,HealthNavalResearchCenter,SanDiegoRecruitsorderedtowashhandsatleast5times/day45%reductioninrespiratoryillnessLeeM,CanadianJournalofInfection,TorontoNursingstudentswashedhandsatleast7times/dayReducednumberofinfections/coldsDoesitwork?RyanM,HealthNa58KarachiStudy-2005SquattersettlementsThreegroups:nosoapplainsoapantimicrobialsoapGroupsreceivingsoap:50%reductioninpneumonia53%reductionindiarrhea34%reductioninimpetigoNobenefitinusingantibacterialsoapKarachiStudy-2005Squatterset59Beforemeals/foodpreparationAfterusingthetoilet/helpingachildusethetoiletBeforeandafterchangingdiapersAfterblowingnose/helpingachildwitharunnynoseAfterplayorhandlingsharedobjectsBeforeinserting/removingcontactlensesBeforeflossingyourteethWhentoWashHandsBeforemeals/foodpreparatio60WetyourhandsApplysoapRubhandstogetherfor20seconds SingTwinkle,TwinkleSongRinsefor10secondsDrywithatowelUsetoweltoturnofftapsandopenthedoorHowtoWashHandsWetyourhandsHowtoWashHand61SoapDoesnothaveantibioticsRemovesdirtandgreasethatattractbadgermsDoesnotpromoteantibacterialresistanceUseplainsoapSoapDoesnothaveantibioticsU62AntibacterialsoappromotesantibioticresistanceAntibacterialsoapaddsantibioticstotheenviromentNomoreeffectivethanplainsoapSoapAntibacterialsoapnotrecommendedAntibacterialsoappromotesan63HandDryingRemoves42%moregermsthanwashingaloneUsecleantowelsAvoidsharingtowelsHotairdryerspromotebacterialgrowthbecausehandsareleftwarmandmoistHandDryingRemoves42%morege64

HandwashingBestwaytostopthespreadofrespiratorytractinfections HandwashingBestwaytostopt65TMAlcohol-basedgels(≥60%alcohol)DonotcauseantibioticresistanceKillmanybacteriaandvirusesNoteffectiveagainstmanygermsthatcausediarrheaShouldnotreplacesoapandwater.Notneededinthehome.AlcoholhandrubsTMAlcohol-basedgels(≥60%al66NotAllBugsAre

CreatedEqualNotAllBugsAre

CreatedEqual67NotAllBugsAre

CreatedEqualBothvirusesandbacteriacauserespiratorytractinfectionsMostrespiratorytractinfectionsarecausedbyvirusesNotAllBugsAre

CreatedEqual68ViralInfectionsMostrespiratorytractinfectionsarecausedbyvirusesViralinfectionsmakeyoufeelsickalloveryourbodyColdsandflu,andmostsorethroats,coughsandsinusinfectionsarecausedbyvirusesAntibioticsDONOTworkagainstvirusesViralInfectionsMostrespirato69LesscommonthanviralinfectionsDonotspreadaseasilyfromonepersontoanotherUsuallyaffectonlyonepartofthebodyPneumoniaandStrepthroatarecausedbybacteriaAntibioticsDOworkagainstbacteriaBacterial

InfectionsLesscommonthanviralinfecti70Antibiotic

ResistanceAntibiotic

Resistance71Antibiotic

ResistanceAntibioticskillmostbacteriabutsomeareabletosurviveSurvivingbacteriahave“antibioticresistance”AntibioticresistantbacteriacannotbekilledbythatantibioticAntibiotic

ResistanceAntibioti72Antibiotic

ResistanceTakingantibioticswhentheyarenotneededmakesyourgoodbacteriaresistantAntibioticresistancecanbetransferredfromonebacteriumtoanother,includingbadbacteriathatcausediseaseAntibiotic

ResistanceTakingan73Antibiotic

ResistanceAntibioticswillnotworkagainstbacteriawithantibioticresistancePeoplecandiefromantibioticresistantinfectionsAntibiotic

ResistanceAntibioti74Antibiotic

ResistanceBacteriahaveantibioticresistancewhentheycannotbekilledbyanantibiotic.Remember,itisthebacteriathatareresistant

NOTYOU!Antibiotic

ResistanceBacteria75

FeverHelpsthebodyfightinfectionOccurswithmostrespiratorytractinfectionsOccurswithbothviralandbacterialinfections FeverHelpsthebodyfightinf76Cold/RunnyNoseColdsarecausedbyvirusesMostcoldsareassociatedwithasorethroatoracoughFluidfromthenosebecomesyellow/greenafter2-3days Thisdoesnot