CDC Public Health Grand Rounds — Combating Resistance: Getting Smart About Antibiotics

CDC Public Health Grand Rounds — Combating Resistance: Getting Smart About Antibiotics


I’m Dr. John Iskander. Welcome to Beyond the Data. I’m here today with Dr.
Lauri Hicks, medical director of CDC’s Get Smart: Know When
Antibiotics Work program. So, Lauri, at this
week’s Grand Rounds, we heard about the
problem of excessive and inappropriate
antibiotic use. What should people take home about that issue in
big picture terms? Well, we know that in
outpatient settings, about 258 million courses of
antibiotics are used each year. And if you think about that,
that’s enough antibiotics for four out of every
five Americans. That’s just an incredible
amount of antibiotic use just in the outpatient setting. And we believe that about 50
percent of all antibiotic use, whether it’s in hospitals
or outpatient settings, is unnecessary or inappropriate. That’s really quite remarkable. Now, one thing we
didn’t have time to talk about during the session, but
which I know is of interest to a lot of people is
antibiotic use in animals, on the farm, so to speak. What should people know about
the science behind that issue and how concerned
should they be? Well, there’s no
question that animal use, animal antibiotic use, has
an impact on human health. And I think about it as antibiotic use anywhere
is antibiotic use everywhere. We have seen outbreaks of
infectious diseases in humans that have been acquired
through our food supply, and so we definitely
need to work to improve animal
antibiotic use. The question is, okay, where
can we make improvements? We know that antibiotics are
still needed to treat infections in animals but there is
a lot of antibiotic use for growth promotion for animals
and so, we support FDA’s efforts to eliminate that practice. Okay. So, coming back to,
again, the more typical setting where our audience might
deal with antibiotics. What should physicians
and others who prescribe antibiotics,
what should their actions be, right now, to better
use antibiotics? Well, we know that providers are
under a lot of time pressures in their offices
and in the hospital to prescribe appropriately,
but we do want them to take a step back and think
about what are the guidelines for appropriate prescribing. There’s lots of guidance out
there to improve prescribing. The first thing we want
providers to ask themselves, “Okay, does this patient
have a bacterial infection?” So, determine the likelihood
of a bacterial infection. Second question-they should
be thinking about, okay, what are the harms
and the benefits of prescribing this antibiotic and weighing the
risks and benefits. We know that antibiotics are
not harmless medications. And then, finally, when
an antibiotic is needed, we want providers to prescribe
the right drug at the right dose and for the right duration. So, those three steps, I
want providers to be thinking about those three steps
every time they’re thinking about prescribing. Okay. Very useful. Now, on the other side of the
prescribing pad, a patient’s and parents of children-what
should they do to educate themselves? What are the actions that
they can take, as patients, to help us all better
use antibiotics? Yeah, it’s without question that
parents and patients play a role in this problem and we
need parents and patients to help us improve
antibiotic use. And one thing I need
parents and patients to think about when they’re going
to their providers is that antibiotics don’t
work to treat viruses. They only work to treat
bacterial infections. So things like colds, flu, lots
of-the coughs this time of year, actually won’t respond
to antibiotic therapy. We also want the parents and
patients to go to the providers and ask, you know,
what’s the best treatment for my child’s illness? If a parent or patient
demands an antibiotic, they’re much more likely to get
one, even if it’s not needed. We used to say, at
the state level, sometimes the best
medicine is no medicine. Absolutely. So, we often say,
“wait and see.” If there is no indication
that an antibiotic is needed, “wait and see” may
be the best approach. So, are there any concluding
points that our audience, perhaps those working in
the public health setting, that they should be armed
with to be able to, you know, do their work better in
promoting antibiotic use or to educate their families
in their communities? What are some take homes for
public health practitioners? Well, I definitely feel like the
public health practitioners play a role in this, as well,
and we must engage state and local health departments
when we’re thinking about improving antibiotic
use in the community. And so, we really need
to work with our state and local health
department partners to get the messages out there. One thing we do every year
is we have an observance, Get Smart About Antibiotics
week, and we partner with our state and local
health department partners. We give them messages to
disseminate to providers and the general public. So we will ask our partners
to work with the messages that we’re providing
and disseminate them through various channels,
whether professional societies or their local partners,
to get the messages out to the general
public and providers. Okay. So, important actions
that can be taken by those who prescribe antibiotics,
by those who take or don’t take antibiotics,
and by those who work in public health to promote
better antibiotic use to better conserve this precious
resource for all of us. Thank you very much, Dr. Hicks. Thank you for joining us
for CDC’s Beyond the Data. Please join us again next month.

Add a Comment

Your email address will not be published. Required fields are marked *