Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die as a direct result of those infections. Improper use of antibiotics has led to these medications losing their effectiveness, and in some cases, has led to spread of infections by “superbugs,” or bacteria that have developed resistance to antibiotics. Patients can play a role in the proper use of antibiotics, too. Froedtert & MCW Infectious disease expert Njeri Wainaina, MD, and pharmacy leader Sara Revolinski, PharmD, share insight on this growing problem and what responsible health care organizations and their patients can do to address it.
What Is Antibiotic Resistance, and How Does It Affect Patient Safety?
Antimicrobials, which include antibiotic medications such as penicillin, have been the cornerstone of medical progress. Success in the care of very premature babies, chemotherapy for cancer, complex surgeries, bone marrow and organ transplants would not be possible without these powerful tools for treating infection.
Yet the very microorganisms these medications target can develop the ability to evade destruction over time if used in appropriately. When any of these “superbugs” infect a person, the options for treatment are limited and often difficult to use safely because of side effects and unfavorable interactions with other medications the person may require. Patients are then at risk for new or worse complications, and, in some cases, there may be no effective treatment options available.
Addressing the Problem
Our health network started an Antimicrobial Stewardship program in 2013 and is tackling the problem with various strategies. First, the education we provide empowers physicians to make optimal antimicrobial prescribing decisions and apply best practices. Pharmacists now play a vital role in communicating important lab results to clinicians along with guidance on changes in antibiotic choice where appropriate. We have partnered with the microbiology lab to take advantage of new technology that identifies infection-causing bacteria faster. Frontline providers, then, can select the most appropriate treatment sooner than they would have using traditional methods. We have also worked with our electronic medical record system to develop processes that make it easy for clinicians to make the correct treatment decisions quickly and efficiently.
We are proud to say we meet guidelines for program support, structure and activity from the Centers for Disease Prevention and Control (CDC). We recently shared our work with other academic medical centers at a national conference.
Other Benefits to Patients
Faster and more accurate diagnosis means patients are put on optimal treatment more quickly and can leave the hospital sooner. We also monitor for side effects so as to detect them early or avoid them altogether. Fewer side effects means fewer complications, shorter hospital stays and a lower likelihood of returning to the hospital. Finally, antibiotics are costly and by reducing antibiotic use, we reduce the volume of medications prescribed to most appropriate use only.
Patients Can Help
While physicians, advanced practice providers and pharmacists must make the right diagnosis, choose the appropriate antimicrobial and help patients use the medication safely, patients and caregivers can play an important role, too.
Knowledge is key. Antibiotics only treat bacterial infections. Viral illnesses cannot be treated with antibiotics. When an antibiotic is not prescribed, ask your doctor for tips on how to relieve symptoms and feel better.
The CDC’s materials for the public are great tools for learning more about what’s got you or your loved one sick, and what medication is most appropriate.
Follow your doctor’s instructions regarding timing and dose of your antibiotic to ensure the greatest benefit and least harm. If you have doubts about your prescription, you should discuss them with your doctor.
Lastly, one of the most powerful tools each of us has in preventing antimicrobial resistance is also one of the most basic: Wash your hands. This is the best way to avoid acquiring and transmitting common infections — preventing the need for medication in the first place!