Intermountain Health: ‘Hey Utahns, Take It Easy On The Antibiotics’

Most doctors know it. Most patients know it. And yet we still have a problem.

A recent study by Intermountain Health and Stanford University has shown once again that Americans are using too many antibiotics, many of which have some serious and devastating side effects.

The new study, one of the most comprehensive studies to document the impact of antibiotic overuse in clinical practice, examined 51 million patient encounters over a 15-year-period and focused on upper respiratory infections, where antibiotics were known to be overprescribed 50% of the time.

Researchers found that some of the most dangerous antibiotics were rarely indicated and commonly used, leading to one in 300 of those patients experiencing side effects dire enough to require a follow up doctor’s visit — or even hospitalization.

Even with new evidence, sometimes patients request or demand an antibiotic, even when it is unlikely to help, or a physician might be tempted to give in and write a prescription, especially if they’re working in a busy setting like an urgent care or emergency department.

The new study finds that overprescribing and inappropriate prescribing of antibiotics is not only leading to antibiotic resistance – but also causing significant patient harm.

According to the Centers For Disease Control (CDC), "at least 30 percent of antibiotics prescribed in the United States are unnecessary."

“Antibiotics are lifesaving drugs, and if we continue down the road of inappropriate use we’ll lose the most powerful tool we have to fight life-threatening infections,” said CDC Director Tom Frieden, M.D., M.P.H. “Losing these antibiotics would undermine our ability to treat patients with deadly infections, cancer, provide organ transplants, and save victims of burns and trauma.”

The national goal, endorsed by the federal government, is to reduce that "overprescribed number" of 30 percent by half.

According to the CDC, health care professionals, health systems, and patients must take these actions to improve antibiotic use:

• Outpatient health care providers can evaluate their prescribing habits and implement antibiotic stewardship activities, such as watchful waiting or delayed prescribing, when appropriate, into their practices.
• Health systems can improve antibiotic prescribing in offices and outpatient facilities within their networks by providing communications training, clinical decision support, patient and health care provider education, and feedback to providers on their performance.
• Patients can talk to their health care providers about when antibiotics are needed and when they are not. These conversations should include information on patients’ risk for infections by antibiotic-resistant bacteria.

The bottom line: If an antibiotic isn't absolutely necessary, don't use it.