Jefferson City health professionals weigh in on antibiotic misuse issue

In the United States, antibiotic-resistant germs cause more than 2 million illnesses annually and at least 23,000 people die due to bacterial infections, according to the Center for Disease Control (CDC).

"With antibiotics, you put pressure on that organism to survive, and when it gets pressure applied you're going to uncork or uncap self-defense mechanisms that have been there the whole time," said Brian Johnson, an infectious disease specialist at St. Mary's Hospital.

The CDC has dedicated efforts to preventing the misuse of antibiotics, including designating a week in November to the cause. It estimates approximately 37,000 lives could be saved from drug-resistant infections by preventing infections and improving antibiotic prescribing over the next five years.

Johnson said there are two common types of misuse with antibiotics: patients are treated longer than necessary for their diagnoses and patients take antibiotics for non-bacterial infections.

Misuse can cause antibiotic resistance, microbes' ability to oppose drug effects, according to the CDC. Resistant strands can spread from person to person, putting a community, country and world at risk.

"This is a battle that these bacteria have been fighting for thousands and thousands of years, and they have all kinds of sneaky ways to survive," Johnson said.

Since the onset of penicillin, the first antibiotic, in the 1940s, the drugs have been a life saver for those suffering all over the world.

"Antibiotics are still a miracle drug as long as they're used correctly," Johnson said. "You cannot underestimate the impact they've had on us as a society, so we need to be concerned about it."

Cold and flu cases, viral infections, peak in December and January, and it is a common misconception in the public that antibiotics treat those illnesses. Johnson said patients sometimes research their symptoms on the Internet, self-diagnose and come into his office requesting antibiotics.

"I spend most of my time talking patients out of antibiotics than talking them into them," he said.

Like all medications, antibiotics can have negative side effects, such as diarrhea and fungal infection, Johnson said.

"The other big issue is that if you're taking a chemical, and it's not treating anything, then you get all the potential risk factors of taking that drug and none of the benefit," Johnson said.

When antibiotics are prescribed correctly, Lianne Twyman, a pharmacist with St. Mary's, said patients don't always finish the full course of the prescription.

"Sometimes patients stop taking their antibiotics when they start to feel better and they might still have a few days left," Twyman said. "They may feel like the infection is treated, but there's still some bacteria."

These patients will often need to be treated with another round of antibiotics, she said, because the bacteria comes back and needs to be wiped out.

Johnson said lack of time with patients can perpetuate misuse.

"It takes time to sit with a patient and explain what we're doing, and right now physicians are pressed more than ever to see patients as quickly as possible. ... When you look at production, physicians are gagged on productivity for pay, and that production means you see as many patients as possible," he said. "That leads to a whole other pressure, but it makes it more difficult to really sit down with a patient and explain everything."

William Klutho, a Jefferson City Medical Group pediatrician, said children less than five years old can suffer from eight to 10 colds a year, but if an illness has lasted for longer than a week, it could be a bacterial infection and be reason for antibiotics. Ear infections are the most common bacterial infection Kluthos treats, and guidelines for treatment have become more stringent, he said. Children, ages six months and older, with ear infections that are one sided, cause no pain or fevers, are under longer periods of observation before prescribed antibiotics.

When children are prescribed antibiotics, Klutho said parents must follow the specific directions on the label and review dosing instructions with a doctor or pharmacist. In order to accurately diagnose children, he added parents should have their children use real names, like of body parts, rather than saying they have an "owie" or a "boo boo."

For more information, go to cdc.gov/drug resistance.