Patients and Physicians Must Work Together to Stop the Spread of Antibiotic-Resistant InfectionsPosted on by
Guest Author: Scott Weissman, M.D.
Seattle Children’s Hospital
In medicine, it is not uncommon for a single patient to provide doctors with an exceptional and life-changing medical education that cannot be acquired from any textbook. In 2006, I met one of those patients – a young woman, whose struggle with persistent urinary tract infections ultimately became an intense crash course in antibiotic-resistant infections.
For several years, we struggled to get her infections under control, but had succeeded only in achieving brief periods of symptom-free health before infection would return, showing up as nausea, stomach pain, flank pain, and headache. We tried antibiotics by mouth, antibiotics by IV, antibiotics into the muscle, even antibiotics directly into the bladder. We tried antibiotics one at a time and in combination. We tried probiotics, and even cranberry juice, along with a full array of alternative therapies that I learned about as we went. Many of these therapies produced their own side effects as well.
No words can really do this experience justice. My patient’s life had become a living nightmare, and as the infectious disease specialist, I felt increasingly powerless to help her.
Ultimately, we learned that she was infected with an E. coli strain called Sequence Type 131, which was not even described in the scientific literature until 2008 – two years into our ongoing treatments. We have now seen this single strain drastically reshape the contemporary treatment of urinary tract infections.
After three years, we had success in keeping the infections at bay, though we scarcely understood what we had done to bring about this long-sought change.
I wish I could say that this patient’s experience was an isolated incidence. But unfortunately it was the beginning of an alarming trend in my practice, which has mirrored the rapid escalation of resistant infections across the United States, and around the world. Antibiotic resistance has quickly become one of the most pressing public health issues of our time.
Looking back, it’s hard to believe that I had never encountered such a hard-to-treat infection before I met this patient. Less than 10 years later, I see patients with multi-drug-resistant infections nearly every day. To think about a similar escalation over the next 10 years is hard to imagine and a very scary prospect.
So what can we do to help ensure that doesn’t happen?
There is still a lot we need to learn about antibiotic resistance if we are going to be successful in this fight. As these stories of medical desperation began to accumulate, it became apparent that the only winners in the serial approach to care (primary care provider, specialist, primary care provider, specialist) were the bacteria. In 2013, I co-founded a dual-disciplinary clinic with my colleagues in urology to manage these complicated patients. At these joint visits, the care providers huddle with patients and families to discuss options and then navigate a care plan that extends symptom-free intervals as long as possible, using antibiotics strategically and sparingly.
But even if you’re not a researcher or a doctor, there is something that all of us can do to help slow down the spread of resistant bacteria: use antibiotics only when necessary.
Increasingly, healthcare facilities are implementing antibiotic stewardship programs to help ensure the appropriate use of antibiotics. And patients have an important role to play as well, by taking steps to prevent infections when possible, talking with their doctors about whether or not an antibiotic is really needed, and, when necessary, taking antibiotics as prescribed.
I’ll be carrying this message and this story with me to Washington, D.C. this week, where I’ll be participating in a briefing for policymakers as part of Get Smart About Antibiotics Week. Together with other advocates, and CDC’s Director Dr. Frieden, we’ll share our expertise and personal experiences to raise awareness about the growing threat of antibiotic resistance – a treatable crisis that requires urgent action.
I encourage you to do something to participate in Get Smart About Antibiotics Week as well. It can be as simple as taking and sharing this quiz, or reading and forwarding an article about this issue. Or consider one of the many ideas for Get Smart activities and events suggested by CDC. It all helps.
On November 18th, as part of Get Smart About Antibiotics Week, The Pew Charitable Trusts will host a briefing in Washington, D.C., to raise awareness about growing threat of antibiotic resistance and the importance of using antibiotics appropriately. Join the briefing via webcast and learn more about this issue, visit