According to the U.S. Centers for Disease Control and Prevention (CDC) doctors are over-prescribing antibiotics essentially empowering antibiotic-resistant bacteria leading to infection around two million people each year and killing about 23,000 Americans annually.
Antibiotics join opiates on a nasty list
Doctors are either in it for the money, far too afraid of a lawsuit, or simply just not as good these days as they need to be in my humble opinion. It’s difficult not to think like this when you read this CDC study in conjunction with having to write about the first decline in U.S life expectancy numbers for the first time since 1993 largely due to opiate overdoses. If that’s not enough, during the NCAA Men’s Basketball Tournament I turned on CBS, from Guatemala, and was quite surprised to see that a drug to treat opiate caused constipation had a thirty second spot. While not the Super Bowl are there really enough people with this problem to warrant an expensive slot for such a commercial?
That’s frightening, but I guess it’s a relief that doctors aren’t just over-prescribing Oxycontin?
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“We were able to conclude that at least 30 percent of the antibiotics that are given in doctors’ offices, emergency departments and hospital-based clinics are unnecessary, meaning that no antibiotics were needed at all,” said lead researcher Dr. Katherine Fleming-Dutra.
But unlike Oxy it won’t kill you, just others by making germs all sorts of strong.
According to the report, colds, bronchitis, sore throats, and sinus and ear infections are the conditions that are most mis/over-prescribed.
“About half of antibiotic prescriptions for acute respiratory conditions were unnecessary,” Fleming-Dutra said.
Analysis of the 2010-2011 numbers
The conclusions reached in this recent report are a result of the good doctor’s and her colleagues investigation of 184,000 outpatient visits by Americans between 2010 and 2011. A staggering 13% of these visits resulting in treatment with antibiotics.
It’s difficult not to put the entirety of the onus of this problem on the doctor as most patients simply follow expensive advice with good reason.
“Nobody should be giving antibiotics for the common cold,” Fleming-Dutra said. “It gets better without antibiotics.”
This recent study was put somewhere it should be with publication in the May 3 issue of the Journal of the American Medical Association which makes considerably more sense than in a pamphlet entitled, “Don’t Listen To Your Doctor,” which has never graced a doctor’s office.
While the numbers are a half-decade old, they are likely the same or worse than what today’s would look like.
“Really, when patients ask for an antibiotic, to some degree they may be asking, ‘Please give me something that will make me feel better,” said said Dr. Sara Cosgrove, an associate professor of infectious disease and epidemiology at Johns Hopkins University in Baltimore. “If we know that an antibiotic is really not likely to make people feel better, we still can provide alternatives for symptom relief that will help people feel better. We need to redirect our thinking a little bit on both sides.”
Cosgrove wrote an accompanying editorial to the study’s publication this week.
Fleming-Dutra was not hesitant to show her agreement: “Doctors think the patient wants antibiotics, and they want the patient to be satisfied with their care, so that often drives clinicians to prescribe when they shouldn’t,” she said.
“Probably most patients can be satisfied without antibiotics, even if they expect them. But it takes more communication between the clinician and the patient to help everybody understand what’s best in those circumstances,” Fleming-Dutra summed up in writing.
What’s the solution?
What’s perhaps most interesting about this study is the proposed simple solution…a poster placed in waiting rooms that made both the doctor and the patient think. But a predicted 20% in over-prescribing of antibiotics is anticipated if these posters are adopted.
“By the time the patient-doctor interaction happens, they’re more on the same page,” Cosgrove said.
Cosgrove also suggests that the simple mandating of a written reason every time a doctor goes the antibiotic route could also help tremendously which, I’m sorry, is a bit scary when you think your doctor might reconsider his or her decision based on having to move their dominant had a bit.
“It’s complex, because all humans are colonized in respiratory tracts with bacteria. You can’t just take a swab of your mouth and look for bacteria, because they’re going to be there,” Cosgrove said.
Cosgrove also believes that once doctors have access to less expensive tests that can distinguish between viral and bacterial infections, cheap antibiotic prescriptions will also decline.