内容概要：抗菌药物在临床上使用是非常常见的且使用率较高的一类药物，也是发展速度最快的一类药 物。近年来，全球抗菌药物市场在需求与技术的双重驱动下稳步扩张，2025年全球抗菌药物市场规模约 为560亿美元。中国市场保持相对稳定，受带量采购的影响，全国抗菌药物市场规模有小幅下降趋势。 2024年我国抗菌药物市场规模1229亿元，预计2025年约为1189亿元。抗菌药物在我国医药临床上已经应 用有七八十年的历史，它主要用于预防、控制和治疗各类感染性疾病，是我国临床应用最广泛的一大类 药物。2024年中国总体医疗机构全身用抗菌药物市场规模1091.8亿元。其中，城市医院抗菌药物销售规 模最大，占据52.2%的份额；县域医院占21.8%；乡镇卫生院占19.0%；社区卫生中心占6.9%。 上市企业：普洛药业(000739)、浙江医药(600216)、华北制药(600812)、京新药业(002020)、川宁生物 （301301.SZ）、东阳光药（06887）、翰森制药（03692）、恒瑞医药（01276）、众生药业（002317） 相关企业：齐鲁制药、正大天晴、青峰药业、浙江海森药业股份有限公司、丹诺医药（苏州）股份有限 ...

Core Viewpoint - The article emphasizes the importance of using the correct temperature and type of water when taking medication, particularly capsules, as using hot water can compromise drug efficacy and pose health risks [1][2]. Group 1: Medication Administration Guidelines - Hot water, especially above 40°C, can damage the efficacy of certain medications, particularly enteric-coated capsules, leading to gastrointestinal discomfort and ineffective treatment [1]. - Capsules, which account for about 20% of prescriptions, are sensitive to heat; gelatin capsules can soften and become sticky in water above 50°C, potentially causing them to dissolve prematurely in the esophagus [1]. - It is recommended to use room temperature or cool water for taking capsules, and to avoid hot water to prevent softening of the capsule shell [1][2]. Group 2: Risks Associated with Improper Water Temperature - Using hot water can lead to esophageal damage, especially with irritating medications like doxycycline and ibuprofen, as the capsule may dissolve too early [1]. - Enteric-coated capsules are designed to protect the drug from stomach acid; using hot water can compromise this protective layer, leading to gastric irritation and ineffective drug absorption [1]. - Some medications require specific storage conditions; for example, soft capsules should be stored at 8°C to 20°C, and using hot water can increase the risk of degradation [1]. Group 3: Recommendations for Specific Medications - Certain medications, such as vitamins and digestive aids, should not be taken with hot water as heat can degrade their effectiveness [1][2]. - Medications containing live bacteria should be taken with cool or warm water, and hot water can kill the active cultures [1]. - After taking capsules, it is advisable to wait before consuming hot beverages to avoid compromising the medication [1]. Group 4: General Medication Taking Practices - It is important to maintain an upright position for at least 5-10 minutes after taking medication to reduce the risk of esophageal injury [2]. - When taking multiple medications, it is advisable to consult a pharmacist to avoid interactions and ensure proper timing between doses [2]. - Crushing or splitting medications should only be done if specified in the instructions or under professional guidance [2].

Core Viewpoint - The article emphasizes that using hot water to take medication, especially capsules, can be detrimental to drug efficacy and may pose health risks [1][2]. Group 1: Risks of Using Hot Water for Medication - Hot water, particularly above 40°C, can damage the efficacy of certain medications, leading to adverse effects such as gastrointestinal discomfort and ineffective treatment [1][2]. - Capsules, especially those made from gelatin, are sensitive to heat; exposure to water at 50°C for just 10 seconds can cause them to soften and become sticky [2][4]. - If capsules dissolve prematurely in the esophagus due to hot water, it can create a high osmotic environment, potentially causing burns and drug-induced esophagitis [4]. Group 2: Specific Health Risks Associated with Capsules - Some capsules are enteric-coated to protect the drug from stomach acid; using hot water can compromise this coating, leading to gastric irritation and ineffective drug delivery to the intestines [5]. - Certain capsules are designed for controlled or sustained release; if the capsule shell is damaged, it may result in rapid drug release, causing adverse reactions [6]. Group 3: Recommendations for Taking Medication - It is advised to use room temperature or cool water (around 40°C) for taking most medications, avoiding temperatures above 60°C [11]. - For specific medications like vitamins, digestive aids, and certain syrups, hot water can degrade their effectiveness or alter their intended action [12][14]. - After taking capsules, it is recommended to wait before consuming hot beverages to prevent compromising the capsule's integrity [6]. Group 4: Proper Techniques for Taking Capsules - Individuals who have difficulty swallowing capsules should adopt techniques such as standing or sitting upright and using a forward-leaning position to facilitate swallowing [8][9]. - It is important to avoid using hot water to prevent softening the capsule shell, which can hinder swallowing [9]. Group 5: General Guidelines for Medication Intake - It is generally recommended to avoid using tea, juice, milk, or alcohol when taking medications, as these can interact negatively with the drugs [16]. - Maintaining an upright position for at least 5-10 minutes after taking medication is advised to reduce the risk of esophageal damage [16][17].

Core Viewpoint - The emergence of drug-resistant pathogens is no longer limited to low-pathogenicity organisms, with an increasing number of high-pathogenicity infectious disease pathogens also exhibiting resistance, including high-resistance clones. Group 1: High-Risk Drug-Resistant Pathogens - Rifampicin-resistant Mycobacterium tuberculosis: China is a high-burden country for multidrug-resistant tuberculosis, with an estimated 28,000 new cases of multidrug/rifampicin-resistant tuberculosis in 2024, ranking second after India [2] - Macrolide-resistant Mycoplasma pneumoniae: This pathogen primarily spreads through droplets, with rising resistance rates to first-line treatments like azithromycin and clarithromycin, particularly among children and the elderly [3] - Ceftriaxone and azithromycin dual-resistant Shigella: First identified in Guangxi in 2015, this pathogen poses a potential threat to children's health due to its dual resistance [4] - Ceftriaxone and quinolone dual-resistant Salmonella: This pathogen, a major cause of infectious diarrhea, has seen rising resistance rates over the past decade, with high-resistance clones spreading through the food chain [5] - Cephalosporin and quinolone dual-resistant Neisseria gonorrhoeae: If widely spread, this dual-resistant strain could make gonorrhea difficult to treat [6] Group 2: Transmission Routes - Waterborne transmission: Pathogens like Shigella and Salmonella can enter rivers, soil, farmland, and aquatic products through contaminated wastewater [7] - Droplet transmission: Mycobacterium tuberculosis and Mycoplasma pneumoniae spread in enclosed spaces like classrooms and subways through airborne droplets [8] - Foodborne transmission: Salmonella is commonly found in undercooked eggs and poultry, posing an infection risk when consumed [9] - Contact transmission: Neisseria gonorrhoeae spreads through direct sexual contact, highlighting the importance of protective measures [10] Group 3: Key Prevention Strategies - Rational use of antibiotics: Antibiotics should be used only with a prescription, at adequate doses, and for the full course of treatment [10] - Good hygiene practices: Regular handwashing, ventilation, and wearing masks in crowded public places can reduce infection risks [11] - Active vaccination: Vaccination is an effective means of preventing infectious diseases, which can help control the development of resistance by reducing infections [12]

Group 1 - The White Dew solar term marks the arrival of autumn and is characterized by increased temperature fluctuations and a greater difference between day and night temperatures [2][3] - It is essential to pay attention to body warmth, especially for the abdomen and feet, to prevent gastrointestinal discomfort [2][3] - Recommendations include layering clothing for temperature regulation and ensuring adequate sleep to enhance immune function [4][5] Group 2 - Dietary adjustments are crucial during the White Dew period, with an emphasis on consuming fresh fruits and vegetables rich in vitamin C, as well as foods high in zinc [6][7] - Women experiencing "blood deficiency" should focus on iron-rich foods and avoid cold and spicy items to maintain health [8][9][10] - Moderate exercise is encouraged to improve blood circulation, with specific recommendations for activities like brisk walking and yoga [12][13] Group 3 - The onset of the White Dew period coincides with a rise in respiratory diseases, necessitating awareness and preventive measures [15] - It is advised not to use antibiotics indiscriminately for common colds and to seek symptomatic treatment instead [16] - Post-infection coughs should not be treated with prolonged use of antiviral medications, and patients should monitor symptoms closely [17]

Group 1 - Hainan has become the first province in China to establish regulatory documents for the circulation management of antibacterial drugs, creating a comprehensive management system for the entire process of production, operation, and use of these drugs [1] - The newly introduced regulations detail requirements for sales management, quality management, prescription review, medication guidance, and product traceability, emphasizing the responsibility of enterprises and personnel for drug safety [1] - The regulations aim to prevent the misuse of antibacterial drugs, which can lead to drug abuse and bacterial resistance, by focusing on retail channels and prescription reviews to prevent illegal distribution [1] Group 2 - Hainan has conducted multiple safety actions over the past three years to strengthen drug retail supervision, addressing issues such as illegal drug purchases, improper sales of prescription drugs, and unlicensed pharmacists [2] - The "Clean Source" action this year has inspected 3,342 retail pharmacies, ordered 311 companies to rectify issues, and initiated 99 legal cases, with three cases referred to law enforcement, ensuring stability in the drug circulation market [2] - The province has implemented a drug traceability platform to enhance the transparency of drug sources and destinations in retail pharmacies [2]