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Doctors aren't only handing out too many antibiotics, they also are frequently prescribing the wrong ones, researchers and public-health officials say.
研究人员和公共卫生官员说，医生不仅滥开抗生素，而且所开抗生素经常是药不对症。
Recent studies have shown that doctors are overprescribing broad-spectrum antibiotics, sometimes called the big guns, that kill a wide swath of both good and bad bacteria in the body. Instead, narrow-spectrum antibiotics, like penicillin, amoxicillin and cephalexin, can usually clear up many infections, while targeting a smaller number of bacteria.
近期的研究显示，医生在处方中过度使用广谱抗生素。这些抗生素有时被称为“重机枪”，可杀死人体内一大批有益和不良细菌。相反，像青霉素、阿莫西林和头孢氨 等窄谱抗生素则通常可在瞄准少量细菌的情况下，治愈很多感染类疾病。
Professional organizations, including the American Academy of Pediatrics, and public-health groups such as the Centers for Disease Control and Prevention are pushing doctors to limit the use of broad-spectrum antibiotics. Among the most common broad-spectrum antibiotics are ciprofloxacin and levofloxacin-a class of drugs known as fluoroquinolones-and azithromycin, which is sold by one drug maker under the brand name Zithromax, or Z-Pak.
包括美国儿科学会(American Academy of Pediatrics)在内的专业组织以及疾病预防与控制中心(Centers for Disease Control and Prevention)等公共卫生组织目前均敦促医生限制使用广谱抗生素。广谱抗生素中，最常见的是环丙沙星和左氧氟沙星（被称为氟喳诺酮类药物）以及阿奇霉素（某制药公司以希舒美(Zithromax)品牌销售）。
Overuse of antibiotics, and prescribing broad-spectrum drugs when they aren't needed, can cause a range of problems. It can make the drugs less effective against the bacteria they are intended to treat by fostering the growth of antibiotic-resistant infections. And it can wipe out the body's good bacteria, which help digest food, produce vitamins and protect from infections, among other functions.
在不必要的情况下，过量使用抗生素和开广谱药物可引发一系列问题。这样做不仅会促进抗药性感染不断扩大，使抗生素在对抗本该对抗的细菌时药效减少，而且会清除体内的有益细菌。这些有益菌可帮助消化食物、产生维生素并保护人体免受感染侵袭等。
In a July study published in the Journal of Antimicrobial Chemotherapy, researchers from the University of Utah and the CDC found that 60% of the time physicians prescribe antibiotics, they choose broad-spectrum ones. 'There is overuse of broad-spectrum antibiotics both in situations where a narrower alternative would be appropriate and in situations where no therapy is indicated at all,' said Adam Hersh, assistant professor of pediatrics at University of Utah and a study author.
《抗菌化学疗法杂志》(Journal of Antimicrobial Chemotherapy)今年7月刊登了一篇研究论文，其中犹他大学(University of Utah)和疾病预防与控制中心的研究人员发现，医师开抗生素时，60%会选择广谱抗生素。犹他大学儿科助理教授、论文作者之一赫什(Adam Hersh)说，滥用抗生素的做法存在于两种情况下，一种是用窄谱抗生素也可获得不错的疗效，一种是完全不需治疗。
The study, which relied on a public database with information on nearly 240,000 visits to doctor's offices and emergency departments, said illnesses for which doctors choose the stronger antibiotics include skin infections, urinary-tract infections and respiratory problems.
这篇研究论文说，医生选择使用药效更强的抗生素对抗的疾病包括皮肤感染、尿路感染和呼吸系统疾病等。该研究以一个公共数据库为基础，该数据库有关于近24万人次到门诊和急诊室看病的信息。
A similar study of children, published in the journal Pediatrics in 2011, found that when antibiotics were prescribed they were broad-spectrum 50% of the time, mainly for respiratory conditions.
2011年刊登于杂志《儿科学》(Pediatrics)上的一篇有关儿童的类似研究发现，医生在开抗生素时，50%开的都是广谱抗生素，主要用于治疗呼吸疾病。
Both studies also found that about 25% of the time antibiotics were being prescribed for conditions in which they have no use, such as viral infections.
这两份研究均认为，医生开抗生素时，约25%开给了病毒性感染等疾病，而抗生素对这些疾病毫无帮助。
'This is upward of 30, 40 million prescriptions a year. And on top of it, these are conditions where antibiotics aren't justified-coughs, colds, bronchitis-and the majority of the antibiotics prescribed are the broad-spectrum antibiotics,' says Dr. Hersh, also a co-author of the Pediatrics study.
《儿科学》杂志上这篇论文的共同作者之一赫什说，每年医生会开超过3,000万到4,000万份处方，最重要的是有些疾病本没有开抗生素的正当理由，如咳嗽、感冒和支气管炎等，而开出的大多数抗生素又是广谱抗生素。
When doctors don't know exactly what type of bacteria is causing an infection they may prescribe a broad-spectrum antibiotic. Ordering up a test to isolate the source of the bacteria can take a day or two to get results. Waiting can risk the infection spreading. Patients also may be in discomfort and not willing to wait.
当医生不确定是哪种细菌造成感染时，他们可能会开广谱抗生素。若为隔离细菌源让病人进行检测，可能需要一两天才能拿到结果。等待期间，感染可能会扩散。病人也可能会觉得身体不舒服，不愿等这么长时间。
Experts say broad-spectrum antibiotics are best used for more severe conditions, such as when a child or adult is in the hospital or has already had multiple courses of antibiotics that didn't work. Someone at risk for infection with resistant bacteria because of repetitive or prolonged antibiotic exposure, such as recurrent ear infections, might also fare better with a broad-spectrum drug.
专家说，广谱抗生素最好是用于较为严重的情况，比如幼儿或成人住院或已经使用多个疗程的抗生素但未能见效。因重复或长期使用抗生素的情况而有抗药菌感染风险者使用广谱抗生素可能也更好。耳部感染反复发作的病人就属于这种情况。
