Antibiotic Misuse Is Putting Increasing Number Of Patients At Risk

Antibiotics are the key weapon for treating all forms of infection, but their judicious use is equally important

The chance discovery of penicillin by Alexander Fleming in 1928 can be described as the singular most important event in man’s fight against infection. Described as a “wonder drug,” it soon paved way for the discovery of many more antibiotics which proved to be highly effective against various infections.

One would be tempted to think that with so many antibiotics around, there would be hardly any room for infections. Alas, that is not true. Indiscriminate and rampant use of antibiotics, even in conditions where their efficacy is doubtful, has been leading to serious side effects. More and more bacteria are developing resistance against the commonly prescribed antibiotics. Unjustified use of antibiotics can seriously jeopardize the health of the patient and even put his life at risk.

But the antibiotic that is prescribed is often wrong or is prescribed for duration far longer than what is necessary. This may lead to serious complications including the development of Clostridium difficile infection, a deadly form of diarrhea.

One in three hospitalized patients of UTI receive wrong antibiotic medicine

For their survey, the CDCs went through the hospital admission details of around 300 hospitals across the US in 2010. It was found that 56% of the hospitalized patients had been prescribed antibiotics at some point of their stay. The researchers at the CDCs focused their attention on patients who had been admitted with the complaints of urinary tract infection (UTI) as they are one of the most common infection for which antibiotics are prescribed. They were amazed to find that one in every three patients admitted for UTI had been prescribed a wrong antibiotic without a proper diagnostic test to identify the causative bacteria, or the duration for which the antibiotic was prescribed was way too long than what is normally advocated.

Most of the doctors prescribe antibiotics as a knee jerk reaction

It was seen that hospitals lack a proper policy regarding prescribing of antibiotics. While certain hospitals preferred to prescribe a single antibiotic for a particular infection, other hospitals prescribed as many as three antibiotics for the same condition.

The researchers feel that such rampant and injudicious prescription of antibiotics is nothing more than a knee jerk reaction of the physicians. They feel pressurized to prescribe antibiotics to satisfy their patients and do not want to take any chance. This can be described as an extremely defensive way of practicing medicine. 

See Also: US Pediatricians: Antibiotics are Over-prescribed to Children

Also, there are instances where the doctors are not properly informed and hence, prescribe a wrong antibiotic or an antibiotic for a wrong duration of time. Vancomycin was found to be the antibiotic most commonly prescribed for too long or in conditions were its use is not justified. What the doctors fail to realize is that their erroneous antibiotic prescribing methods put increasing number of patients at a higher risk of developing drug resistant infections.

Alarming Rise In Clostridium Infections Due To Indiscriminate Use Of Antibiotics

Clostridium difficile is one of the many bacteria which are normally found in our gut. But under the influence of strong antibiotics, it tends to overgrow as the antibiotics wipe out the bacteria which normally compete with it for survival. When C. difficile grows unchecked, it may produce dangerous toxins which may lead to intractable diarrhea. The condition can soon turn deadly and is associated with a high mortality rate.

If the use of antibiotics, whose indiscriminate use is associated with Clostridium difficile infection, is reduced by 30%, the deadly infection caused by this bacterium can be lowered by a whopping 26%.

There is an urgent need to improve antibiotic prescription policies followed by various hospitals

The CDCs have recommended that hospitals should improve upon their existing antibiotic prescription policies. In order to prevent drug resistance, following steps should be taken:

• The physicians should be educated about drug resistance and be advised to evaluate the disease completely before prescribing any antibiotic.
• The antibiotics should be prescribed for an optimal period.
• The choice of antibiotic is of extreme importance.
• Strong antibiotics should be reserved only for dealing with very serious infections.
• Only the minimal number of antibiotics required to cover a disease, should be prescribed.
• Patients should also be advised that antibiotics are not required in all cases. They should be told that antibiotics do not have any role to play in case of viral infections.
• The importance of completing the entire course of the antibiotic which has been prescribed to the patients and not leave the course midway after improvement in symptoms of the disease should be stressed upon the patients by their treating physicians. Leaving the antibiotic course midway may leave back some bacteria which may become more resistant.
• All steps should be taken to ensure good hygiene in the hospital so that the use of antibiotics is minimized. Caretakers should be taught to wash their hands before and after they touch a patient so that they do not carry disease organisms from one patient to another.
• The CDCs also advise the physicians to reassess their patients 48 hours after they have been put on some antibiotic. This would help them in deciding whether the type of antibiotic, its dosage and its duration for prescription is appropriate or some change is needed.

Antibiotic resistance is the biggest headache for most physicians. It can lead to illness that lasts longer making it difficult to treat, extending the patient’s stay in the hospital and increased medical expenditure. 

See Also: Persistent Bacterial Infections And Resistance To Antibiotics

Following the above mentioned steps would go a long way in reducing the development of antibiotic resistance in disease causing organisms. Controlling antibiotic resistance would not only help current patients but would also help preserve the usefulness of presently available antibiotics for future patients. Researchers have opined that big hospitals can save up between $200,000 and $900,000 annually by adopting these simple measures. According to the CDCs, implanting a proper antibiotic prescribing policy in the hospitals can reduce the rate of C. difficile infection by almost 50% in a 5 year period.