Overuse of Antibiotics

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Overuse of Antibiotics

by Hana R Solomon, MD

Antibiotics are no longer the powerful tool they once were. No longer can we count on antibiotics to effectively and dependably destroy harmful bacteria. Part of this disturbing trend is due to overuse because the more we use antibiotics the more we give bacteria an opportunity to develop resistant strains. Now this resistance is becoming a significant threat to society.

The costs of overuse are significant both to our health and to our resources. Recently the CDC has estimated that treatment of infections caused by bacteria resistant to antibiotics is costing more than $4 billion annually.

There are many factors associated with growing resistance. For years we have seen an increase in the use of antimicrobials both in hospitals and in the community. Antibiotics are often used empirically and started before the specific pathologic bacterium has been identified. Broad-spectrum antibiotics that use a 'shotgun' approach are used for prolonged periods in attempts to treat severe infections. In addition, if one course of antibiotics does not seem to be completely effective, second and third courses are frequently given Ð often due to patient demand.

Prolonged hospitalizations of severely ill patients and patients with compromised immune systems require additional use of antibiotics. The increased use of intravascular devices and catheters create more sites for infection, a problem all too often compounded by inadequate infection control procedures.

The medical community can help curb this serious problem of developing resistance by offering the patient narrow spectrum antibiotics only for identified infections, and by using a shorter duration of therapy when appropriate. Educating patients about the ineffectiveness of treating viruses with antibiotics can prevent unnecessary use. But perhaps even more importantly, doctors need to educate their patients regarding the risk of using antibiotics and spend more time discussing prevention.

Health care consumers would be wise to ask if they can avoid using antibiotics or if there are any other options to consider. Consider watchful waiting as an option. If an antibiotic is prescribed, ask if it is specific for the problem being treated. Do not assume that all illness will respond to antibiotics; avoid treating viruses with medications that are specific for bacteria. Do not expect an antibiotic for treatment of a cold. In fact, 'If you seek treatment by a doctor for a cold, it will take a week to resolve but if you use home remedies, the cold will last 7 days'. So do what is possible to prevent bacterial infections by using appropriate self-care modalities to stay healthy.

For example, if a sinus infection is just getting started and antibiotics are being discussed, why not consider nasal washing as a first line of defense? Washing the nose, drinking plenty of fluids, and taking time to rest can clear the sinuses and avoid the need for antibiotics. If recurrent sinusitis is an issue, incorporate nasal washing into a daily routine so that the number of infections are reduced or prevented altogether. Similarly, asthma control is best addressed when the nose is free of irritants and debris. In fact, it has been shown that fewer drugs are needed to control asthma if the nose is clear. These prevention techniques are proven methods that can reduce the need for antibiotics.

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