Author: Rear Admiral Boris D. Lushniak, MD, MPH
Acting Surgeon General
Antibiotics are powerful tools for fighting illness and disease, but some of these drugs are being rendered less effective due to overprescribing, misuse, and bacterial evolution.
Many of our advances in medical treatment, such as chemotherapy and transplants, depend on antibiotics’ ability to fight bacterial infections. These drugs also help manage infections that happen as a result of surgery. Unfortunately, bacteria learn in a very short time how to outsmart antibiotics. Resistant bacteria can easily multiply, spread, and share their resistance with other bacteria.
A recent report from the Centers for Disease Control and Prevention found that more than two million people in the U.S. become sick every year with antibiotic-resistant infection. At least 23,000 die as a result. Antibiotic-resistant infections can also add considerable, and many times avoidable, costs to patients and the healthcare system due to longer illness, lost productivity, and more expensive hospital stays.
The President’s budget, which was released on Tuesday, includes $30 million for a domestic initiative to establish a robust infrastructure that can detect antibiotic resistant threats and protect patients and communities.
Antibiotics are among the most commonly prescribed drugs used in human medicine, yet up to 50% of all the antibiotics used in hospitals are not needed or are incorrectly prescribed. Each one of us can help limit antibiotic resistance by changing the way we use antibiotics.
As a patient, discuss with your prescriber the role antibiotics might play in treating your current illness. and be careful about directly requesting antibiotics Remember, antibiotics are powerful drugs and may have considerable negative side effects, so do not take antibiotics that were not prescribed to you for your current illness. Encourage your family and friends to use antibiotics wisely and to remember simple and effective germ-fighting steps such as hand washing.
Clinicians and leaders of health care facilities should ensure the facility has an antibiotic stewardship program that includes, at a minimum, these 7 steps:
- Leadership commitment: Dedicate necessary human, financial and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to handle drug issues.
- Action: Implement at least one action to improve prescribing. For example, require “antibiotic timeouts” within 48 hours of starting an antibiotic to double check drug choice, dose, and duration.
- Tracking: Monitor antibiotic prescribing and resistance patterns.
- Reporting: Regularly report antibiotic prescribing and resistance information to clinicians and other key staff.
- Education: Educate clinicians about resistance and prescribing improvement.
In addition to sharing prescribing improvement recommendations and tools with clinicians
and administrators, the CDC is working to expand the National Healthcare Safety Network to help hospitals track antibiotic use and resistance.
While it is not possible to completely stop antibiotic resistance, we can slow the process considerably by carefully using antibiotics so that we preserve the drugs we have now and ensure the longevity of the new drugs we’re working to develop.
To learn more, visit CDC’s website: http://www.cdc.gov/drugresistance/index.html. To read recent publications, visit CDC’s March Vital Signs on antibiotic prescribing in hospitals, http://www.cdc.gov/vitalsigns/, and CDC’s 2013 antibiotic resistance threatsreport, http://www.cdc.gov/drugresistance/threat-report-2013/index.html.