Just Say No To Antibiotics!

While antibiotics can cure many life-threatening conditions, the overuse of antibiotics contributes to a number of problems, including resistant strains of bacteria that can be difficult to treat. Read on to learn why you should consider other options to antibiotic prescriptions for various health conditions.

Millions of children visit doctors for ear infections each year.  This happens to be the most common reason why kids are prescribed antibiotics.  Yet, new studies suggest these drugs do virtually nothing to help most kids recover faster while they often cause far worse side effects.  While one of the most common types of childhood ear infections, acute otitis media, may be caused by bacteria, the majority are caused by a virus, which won’t be impacted by antibiotics.[1. Hicks L. CDC Commentary: Don’t Give In and Give Those Antibiotics! Available at: http://www.medscape.com/viewarticle/730224 Accessed November 23, 2010.]

The CDC (Center for Disease Control):  “It is estimated that roughly 50% of antibiotics are unnecessarily prescribed in both inpatient and office settings. This is especially true for Upper Respiratory Infections (URIs) like cough and cold illness, most of which are caused by viruses. Prescribing antibiotics for viral URIs is the most common misuse of these drugs. These infections will resolve on their own without antibiotics. In children, antibiotics are the most common cause of emergency department visits for adverse drug events. Most people don’t realize that antibiotics are dangerous. Children may have up to 9 colds each year. Four out of 10 children who present to an outpatient provider with the common cold receive an antibiotic, even though antibiotics are never indicated for a common cold.”

Both the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians have recommended since 2004 that doctors hold off on prescribing antibiotics for ear infections, at least initially, as the American Academy of Pediatrics states:

“While the number of office visits for otitis media with effusion (middle ear fluid -OME) have decreased over the past decade from 25 million in 1990 to just 16 million in 2000, the number of antibiotic prescriptions to treat OME has remained constant.  At the same time, concerns about the rising rate of antibiotic, or antibacterial use and resistance have emerged.” [2. JAMA. 2010 Nov 17;304(19):2161-9]

Despite this warning and studies that came out over a decade ago saying the routine use of antibiotics for pediatric ear infections produces little health benefit while contributing to the spread of drug-resistant bacteria, these drugs are still widely over-prescribed for this purpose.  It’s easy to believe that one round of antibiotics won’t hurt your child.  In fact, many believe it’s absolutely necessary for nearly all infections, especially for those in their children.  But bacteria are rapidly growing accustomed to this antibiotic exposure, and they’re quickly developing resistance.  Antibiotic-resistant infections now claim more lives each year than the “modern plague” of AIDS, and the U.S. health care system spends nearly $2 billion a year to treat these drug-resistant bacteria.

In fact, a 1997 JAMA study found that frequent use of antibiotics for common ear infections raises risks that children will harbor drug-resistant bacteria during subsequent illness. The researchers found that children whose previous ear infections were treated with antibiotics had a rate of Ampicillin (amoxicillin)-resistant bacteria that was three times higher during subsequent ear infections.[3. American Academy of Pediatrics, 2004] As long as we continue using potent antibiotics for minor infections or those caused by viruses, this trend of creating ever more resistant strains of infections will continue.  Whenever you use an antibiotic, you’re increasing your susceptibility to developing infections with resistance to that antibiotic, resistance that can last up to a year and you can become the carrier of this resistant bug, and spread it to others.

Are you or your family members using antibiotics in a way that will ruin your chance of fighting off future illness?  Keeping your immune system strong is the only way to truly fight off infections.

The biggest problem is that adults want them for themselves and their parents and doctors, rather than disappoint or lose a patient, now make these dangerous drugs incredibly easy to get.  The CDC offers these solutions to physicians who feel they don’t have the control or ability to stop the overuse of antibiotic drugs:

Here are 4 communication strategies that clinicians can use to help prevent patient requests for an inappropriate antibiotic or to respond to such requests:

1.     Provide a specific diagnosis to help patients feel validated. For example, say “viral bronchitis” instead of referring to an illness as “just a virus.”

2.     Recommend symptomatic relief and share normal findings as you go through your examination.

3.     Discuss potential side effects of antibiotic use, including adverse effects and resistance. Many patients don’t realize that antibiotics can be harmful.

4.     Lastly, explain to the patient or parent what to expect over the next few days—including that you will reevaluate their situation and prescribe antibiotics if it becomes medically appropriate.

They should say, “Get adjusted and get to a Makeover.”

4JAMA November 26,1997;278(20):1643-1645