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Preserving Antibiotics Key to Protecting Patients

Posted on by CDC's Safe Healthcare Blog
Rear  Admiral Boris D. Lushniak, MD, MPH
Rear Admiral Boris D. Lushniak, MD, MPH

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: To read recent publications, visit CDC’s March Vital Signs on antibiotic prescribing in hospitals,, and CDC’s 2013 antibiotic resistance threatsreport,

Posted on by CDC's Safe Healthcare Blog

3 comments on “Preserving Antibiotics Key to Protecting Patients”

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    This is a problem for me as I have ongoing chronic sinusitis that has lasted for eight years; I have had two operations with six months relapse on the first operation and about one year on the second operation.

    I am back to square one again and having two week doses of strong antibiotics start feeling better for about four days then getting bad again so I live on an ongoing cycle of antibiotics. Also had one year of really bad mrsi infection to face neck and back before they picked it up.

    Where do I go from here?

    This article highlights the need for wise stewardship of antibiotic therapy in ALL clinical settings. Extended care facilties are the weakest link. Not only are there few safeguards in place regarding antibiotic prescription, often there is inappropriate assessments regarding their need as well.

    I see this everyday in my work: vague or symptoms with multi-causal origins routinely bring on Cipro, Levaquin and other broad-spectrum antibiotics prescription for suspected UTIs. Many clinicians don’t distinguish enough between passive colonization and active infection because they look narrowly at urine specimen results and at not broader clinical manifestations (or lack of same).

    Because the frail elderly circulate between acute hospitalization and long-term care settings, they often become carriers of multi-drug resistant microbes and circulate these to the larger community. A more aggressive and consistent outreach and education program to LTC care facilities is sorely needed.

    What is really needed is a quick reliable test that would allow the physician to know and the patient to be convinced that their sinusitis or bronchitis is viral and not bacterial. As a physician who grew up in an age when bacterial meningitis was rampant and the cause frequently linked to acute otitis media, the default was to go with antibiotics first. HiB and Pneumococcal Vaccines have changed that, but it takes great personal effort to change that mindset, and takes an emotional toil through the day of convincing patients, parents and grandparents that antibiotics are not indicated, yet. All it takes is once for the patient not to get better and improve once antibiotics are finally started to destroy all your education you have done with that patient and 10 of their friends.

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