Author/Editor		Grmek-Košnik, Irena
Title		Odpornost bakterij proti antibiotikom
Translated title		Bacterial resistance to antibiotics
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 40, št. 11-12
Publication year		2001
Volume		str. 388-90
Language		slo
Abstract		Antibiotic resistance was once confined primarily to hospitals but is becoming increasingly prevalent in family practice settings, making daily therapeutic decision more challenging, rising treatment costs, complicating therapeutic choices and increasing risk of patient morbidity and mortality. Up to 50 percent of antibiotic prescriptions in community settings are believed to be unnecessary. The most common causes are unreasonable patient expectations or demands, lack of time to explain to patients (or parents) why antibiotics are unnecessary, and misdiagnosis. The physician has to resist a patient's demands for unnecessary antibiotics. He has to take time to explain to patients and parents when antibiotic use is appropriate and when it is not, or can be even harmful. In most cases antibiotic therapy can be postponed until the result of microbiologic examinations which is mostly available in 24 hours. When antibiotic is urgently needed, selection of targeted-spectrum antibiotics is appropriate to preserve the normal commensally flora. Antibiotics for viral should not be prescribed infections. The latest available data on local resistance trends should always be considered.
Summary		Odpornost bakterij proti antibiotikom je bila sprva omejena na bolnišnice, sedaj pa se je problem pojavil tudi v osnovni zdravstveni dejavnosti. Zato so splošni zdravniki soočeni s težavnejšimi terapevtskimi odločitvami, naraščajočimi stroški zdravljenja in večjim tveganjem za neugoden izid pri zdravljenju bolnikov. Po podatkih iz literature se do 50% antibiotikov predpiše po nepotrebnem. Najpogostejši vzroki za nepotreben predpis antibiotikov so zahteva bolnika za antibiotik, negotovost zdravnika, pomanjkanje zdravnikovega časa za razlago bolniku oz, staršem, zakaj antibiotik ni potreben, in napačna diagnoza. Zdravnik ne sme ustreči zahtevi bolnika za antibiotik, če ta ni potreben. Bolniku je potrebno razložiti, kdaj je jemanje antibiotika koristno, kdaj pa je neustrezno oz. škodljivo. Pred jemanjem antibiotika naj se kužnina čim večkrat pošlje v mikrobiološko preiskavo in počaka na začasen rezultat analize, ki se ponavadi lahko dobi že do naslednjega dne. V primeru, da je antibiotik potreben takoj, naj se zdravnik odloči za antibiotik z ozkim spektrom delovanja, ker ta ohranja komenzalno floro. Za virusne okužbe naj se ne predpisuje antibiotik. Pri predpisovanju antibiotika je potrebno poznati lokalno odpornost bakterij proti antibiotikom.
Descriptors		DRUG RESISTANCE, MICROBIAL ANTIBIOTICS PRESCRIPTIONS, DRUG RESPIRATORY TRACT INFECTIONS URINARY TRACT INFECTIONS