Survey respondents corroborated what Atlanta pediatrician Dr. Hansa Bhargava has discovered in her own practice: “There’s a lot of room for patient education,” she said.
Bhargava, former lead physician in urgent care at Children’s Health Care of Atlanta, said parents routinely ask for antibiotics, even when a child’s symptoms don’t warrant their use. She’s also seen a rise in drug-resistant skin infections.
Antibiotics have played a key role in relief from disease, but widespread use of antibiotics since the 1940s has had some unintended consequences, chief among them drug resistance and anti-microbial resistance. That trend threatens to make some diseases untreatable — including gonorrhea — and causes longer, more costly hospital stays and poorer outcomes.
The Centers for Disease Control and Prevention reports that each year in the U.S., at least 2 million people become infected with bacteria resistant to antibiotics, and at least 23,000 people die as a direct result of antibiotic-resistant infections.
People infected with MRSA — a drug-resistant staph — are 64 percent more likely to die than those with non-MRSA infections, according to the World Health Organization. That same organization reported 450,000 new cases of multi-drug-resistant tuberculosis worldwide in 2012.
Doctors have played a role in the overuse of antibiotics.
Physicians and nurse practitioners told surveyors they prescribed antibiotics about 20 percent of the time when they weren’t sure they were necessary; physician assistants said they did this 25 percent of the time.
Many prescribed to be on the safe side, or because a patient couldn’t afford a test, or because of malpractice concerns. “Clinicians continue to prescribe antibiotics for dubious clinical reasons,” wrote the survey authors, Susan Yox and Laurie Scudder.
The authors added that patients need to be smarter. But clinicians can’t be the only source of information, said Bhargava, who serves as a pediatrician expert for WebMD. “(Patients) are in the doctor’s office 15 minutes of a day, once every three months or so,” she said. The rest of the time, patients need to look after their own education.
The survey also showed some positive results: If a clinician declines to prescribe antibiotics, most patients are satisfied when a doctor outlines the reasons behind the decision. “The good news is a majority were fine with the explanation,” said Bhargava. “If the conversation happens between the doctor and patient, the outcome is good.”
For more information about the survey, go to www.medscape.com/features/slideshow/public/antibiotic-misuse.
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