In 2003, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) joined efforts to educate the public and health care providers about the dangers of inappropriate use of antibiotics. The evidence-based practice guidelines combine data from many studies to outline the most efficacious use of antibiotics. Nurses should include some of the following points about the risks and dangers of antibiotic abuse in the patient education plan:
• Explain clearly that a particular antibiotic is effective against only certain bacteria and that a culture needs to be taken to identify the bacteria.
清晰说明特定抗生素只对特定细菌有效，应通过细菌培养确认细菌。
• Explain that bacteria can develop resistant strains that will not be affected by antibiotics in the future, so use of antibiotics now may make them less effective in situations in which they are really necessary.
• Ensure that patients understand the importance of taking the full course of medication as prescribed, even if they feel better. Stopping an antibiotic midway through a regimen often leads to the development of resistant bacteria. Using all of the medication will also prevent patients’ saving unused medication to self-treat future infections or to share with other family members.
• Tell patients that allergies may develop with repeated exposures to certain antibiotics. In addition, explain to patients that saving antibiotics to take later, when they think they need them again, may lead to earlier development of an allergy, which will negate important tests that could identify the bacteria making them sick.
• Offer other medications, such as antihistamines, decongestants, or even chicken soup, to patients who request antibiotics; this may satisfy their need for something to take. Explaining that viral infections do not respond to antibiotics usually offers little consolation to patients who are suffering from a cold or the flu.
1. A microbe acquires antibiotic resistance by which means?
A. Development of medication resistance in the host
B. Over-riding of the minimum bactericidal concentration
C. Incorrect dosing, which contributes to ribosome mutations
D. Transfer of DNA coding to other bacteria
2. The nurse identifies which host factor as the most important when choosing an antimicrobial drug?
A. Age
B. Competent immune function
C. Genetic heritage
D. Previous medication reactions
本期ISPN Review答案： 1. D. Transfer of DNA coding to another bacteria
All alterations in structure and function result from changes in the microbial genome. The microbe, not the host, becomes medication resistant. Genetic changes in a microbe result either from spontaneous mutation or from acquisition of DNA from conjugation with other bacteria. The minimum bacterial concentration (MBC) is used in testing for drug sensitivity. Incorrect dosing does not lead to microbe mutations.
2. B. Competent immune function
Two factors—host defenses and the site of infection—are unique to the selection of antibiotics. It is critical for success that antibiotics act synergistically with the immune system to subdue infection. Other host factors, such as age, genetic heritage, and previous drug reactions, are the same factors that must be considered when choosing any other medication.
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