抗生素（antibiotics）
共用题干 第三篇Be Alert to Antimicrobial（抗微生物的）ResistanceThe ability of micro-organisms to find ways to avoid the action of the drugs used to cure the infectionsthey cause is increasingly recognized as a global public health issue.Some bacteria have developed mecha-nisms which make them resistant to many of the antibiotics（抗生素）normally used for their treatment. They are known as multi一drug resistant bacteria,posing particular difficulties,as there may be few or no alternative options for therapy.They constitute a growing and global public health problem. WHO suggests that countries should be prepared to implement hospital infection control measures to limit the spread of multi-drug resistant strains（菌株）and to reinforce national policy on prudent use of antibiotics , reducing the generation of antibiotic resistant bacteria.An article published in The Lancet Infectious Diseases on 1 1 August 2010 identified a new gene that enables some types of bacteria to be highly resistant to almost all antibiotics.The article has drawn attention to the issue of antimicrobial resistance,and,in particular,has raised awareness of infections caused by multi- drug resistant bacteria.While multi-drug resistant bacteria are not new and will continue to appear,this development requires monitoring and further study to understand the extent and modes of transmission,and to define the most effec-tive measures for control.Those called upon to be alert to the problem of antimicrobial resistance and take appropriate action in- clude consumers , managers of hospitals , patients , as well as national governments , the pharmaceutical（制药 的）industry,and international agencies.WHO strongly recommends that governments focus control and prevention efforts in the following areas like surveillance for antimicrobial resistance;rational antibiotic use,including education of healthcare workers and the public in the appropriate use of antibiotics;introducing or enforcing legislation related to stopping the selling of antibiotics without prescription;and strict adherence to infection prevention and control measures, including the use of hand-washing measures,particularly in healthcare facilities.Successful control of multidrug-resistant micro-organisms has been documented in many countries,and the existing and well-known infection prevention and control measures can effectively reduce transmission of multi-drug resistant organisms if systematically implemented.WHO will continue to support countries to develop relevant policies,and to coordinate international efforts to combat antimicrobial resistance.Antimicrobial resistance will be the theme of WHO's World Health Day 2011.The word"prudent"in Paragraph 1 is closest in meaning to_________.A:unwiseB:carefulC:wastefulD:widespread
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Doctors must stop telling patients to finish an entire course of antibiotics because it is driving antimicrobial resistance,and patients should be encouraged to continue taking medication only until they feel better to avoid the overuse of drugs,experts from bodies including Pubtic Health England and the University of Oxford are now advising.Current guidance from the NHS and the World Health Organisation says it is essential to'finish a course'of antibiotics to avoid triggering more virulent forms of disease.But in a new article in the British Medical Journal（BMJ）,10 leading experts said the public health message is not backed by evidence and should be dropped.They claim it actually puts the public at greater risk from antimicrobial resistance."Historically,antibiotic courses were driven by fear of undertreatment,with less concern about overuse,"said lead author Martin Llewelyn,professor of infectious diseases at Brighton and Sussex Medical School."The idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by evidence,while taking antibiotics for longer than necessary increases the risk of resistance.We encourage policy makers,educators,and doctors to stop advocating'complete the course'when communicating with the public."Fears that stopping antibiotics early could trigger more dangerous forms of disease date back to Alexander Fleming who found that bacteria quickly become~acclimatised to penicillin and patients who take insufficient doses may transmit a more dangerous strain to family members.In his Nobel Prize acceptance speech in 1945,Fleming warned:"If you use penicillin,use enough."But in the BMJ article the experts argue that when a patient takes any antibiotics it allows dangerous strains of bacteria to grow on the skin and gut which could cause problems later.The longer the course,the more the resistance builds.They also warn that current guidance ignores the fact that patients often respond differently to the same antibiotic,with some needing longer courses than others.Commenting on the research Alison Holmes,Professor of Infectious Diseases at Imperial College London said it was'astonishing'that doctors still do not know the optimum duration for taking drugs even though a long course raises the risk of bacterial resistance."The'complete the course'message directly conflicts with the societal messages regarding the changes needed in behaviour and attitudes to minimise unnecessary exposure to anribiotics,"she said.However.Professor Helen Stokes-l.ampard.Chair of the Royal College of GPs,said:"Recommended courses of antibiotics are not random-they are tailored to individual conditions,and in many cases courses are quite short,for example for urinary tract infections.three days is ofren enough to cure the infection.We are concerned about the concept of patients stopping taking their medication mid-way through a course once ihey'feel better'.because improvement in symptoms does not necessarily mean the infection has been completely eradicated.It's important that patients have clear messages and the message to always take the full course of antibioiics is well known-changing this will simply confuse people."Chief medical officer Dame Sally Davies,also said that the message to the public shoulcl remain unchanged until there was further research."National Institute for Health and Care Excellence is currently developing guidance for managing common infections,which will look at all available evidence on appropriate prescribing of antibiotics,"she said."The Departmcnt of Health will continue to review the evidence on prescribing and drug resistant infections.As we aim to continue the great progress we have made at home and abroad on this i-ssue."Alexander Fleming cautioned thatA.more studies were required to decide whether to change guldance for using antibiotics to the public. B.enough antibiotics should be used to prevent the spread of deadlier forms of disease. C.patients under antibiotic treatment had long been worried about overuse. D.patients should stop taking antibiotics as soon as they became unnecessary for them. E.many advised courses were too short to treat diseases as minor as urinary tract infections. F.changing the'always complete the course'message might bring about confusion to people. G.doctors were supposed to have known the ideal length of antibiotic treatments.
全身情况不良病人选用（）A、窄谱抗生素B、广谱抗生素C、抑菌性抗生素D、杀菌性抗生素E、联合应用抗生素
广谱抗生素治疗中发生真菌感染，除选用抗真菌药物外，宜换用（）A、窄谱抗生素B、广谱抗生素C、抑菌性抗生素D、杀菌性抗生素E、联合应用抗生素
混合感染时选用（）A、窄谱抗生素B、广谱抗生素C、抑菌性抗生素D、杀菌性抗生素E、联合应用抗生素
根据抗生素的化学结构，抗生素分为（）、（）、（）、（）和多肽类抗生素；根据抗生素的合成途径，抗生素分为（）、肽类衍生物抗生素和糖类衍生物抗生素。
半合成抗生素（semi-synthetic antibiotics）
