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New Antibiotics Inject Hope, Underscore Misuse
This week's approval
of a new class of antibiotics provides welcome relief for patients
who, through no fault of their own, increasingly find themselves
infected by drug-resistant bacteria. The drug, Zyvox, can fight
deadly bacteria that had learned to defeat the best antibiotics
doctors could throw at it. And more arrows will fill doctors' quivers
soon, with six drugs awaiting FDA approval and another 11 in late
stages of clinical testing.
This good news in the battle against bacterial infections won't last long, however, if doctors don't change their reckless prescribing habits.
About a third of the 150 million antibiotic prescriptions written each year are inappropriate. One study found that as many as 70% of patients with colds and upper respiratory tract infections and other ailments most often caused by viruses -- which can't be treated by antibiotics -- were prescribed antibiotics anyway.
Worse still, patients who have bacterial infections often aren't told why they should finish the entire regimen: Surviving bacteria develop into anti-biotic resistant strains.
The result of the vast misuse is now painfully clear. About 25% of pneumococcus germs -- which cause sinus and ear infections and can cause bacterial pneumonia, bloodstream infections and meningitis -- are now resistant to penicillin, up from 5% in the 1980s. Other bugs have shown similar resistance patterns.
Doctors confronted with these alarming trends are quick to point fingers. A forthcoming survey of Massachusetts doctors by the Alliance for the Prudent Use of Antibiotics (APUA), for instance, finds doctors often blaming patients who demand antibiotics when they feel bad. Other doctors complain about drug company marketing. Still others say heavy workloads imposed by HMOs makes proper diagnosis difficult.
Some medical societies, along with the Centers for Disease Control and university researchers, are trying to change these bad habits. The American Academy of Pediatrics, for instance, sends out direct mailings to its members. APUA has a simple, effective pamphlet that explains the risks of misuse to patients. And a study published last spring finds that an aggressive information campaign can sharply cut antibiotic prescriptions. More should be done along these lines.
But enough already is known about the risks of antibiotic overuse that doctors shouldn't wait for such handholding. They just need to spend a little time with their patients, telling them "no" when appropriate.
Until doctors get smarter about antibiotic use, the bugs will always be one step ahead of the latest drug.
Preventive measures
Patients can do several things to prevent antibiotic-resistant infections in themselves and others:
- Never take an antibiotic for a viral infection such as cold, cough, or flu.
- Always wash your hands thoroughly with soap and water.
- Always handle raw food properly.
- Take an antibiotic exactly as the doctor prescribes.
- Take the antibiotic until it is gone, even if you are feeling better. Never save the medication to treat yourself or others later.
Source: Centers for Disease Control and Prevention.
Copyright USA Today Information Network Apr 21, 2000
Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.
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