October 2, 2017
This is a continually evolving problem for all of us. Historically, significant antibiotic resistance was confined to the hospitals and intensive care units primarily. Over the past decade, these bacterial resistance issues have entered the everyday world with the likes of MRSA, methicillin resistant Staphlococcus aureus.
Every day we are seeing children with MRSA abscess/skin infections. Luckily, we still have 2 good oral antibiotics to fight this trouble maker. Hypothetically, these antibiotics could start to fail. Then what? Death is the outcome for many untreatable serious infections. Why would this problem exist?
We have abused antibiotics in the patient care world for decades by over treating viral disease as bacterial. Unfortunately, I still see too many patients coming in for follow up after being on vacation or out of town with 10 day courses of antibiotics for 2 days of viral cold symptoms. The use of these drugs indiscriminately is a danger to everyone over time.
We are using antibiotics like water in the animal/food industrial complex. We use more antibiotics in animals than in all Americans combined. Why? To enhance growth and control infections that stem from living in cesspools of close quartered environments. This practice is far from coming to an end.
According to the CDC: because of the link between antibiotic use in food producing animals and the occurrence of antibiotic resistant infections in humans, antibiotics should only be used in animals with veterinary oversight and only to treat and manage infectious diseases, not to promote growth.
What are the cold hard facts? Over 2 million Americans become infected with resistant bacterial organisms yearly. The subsequent death rate is over 25,000. That is a lot of loved ones to give up to a preventable issue. I am not comfortable with this for our society and especially not for my community.
Who is at the greatest risk? Patients with cancer, kidney disease receiving dialysis, immune system defects and those receiving major surgeries.
What can we do to stem the tide of this mess?
1) Avoid using antibiotics unless prescribed by a physician or other licensed provider. Antibiotics are drugs with significant side effects including the most dangerous one: disrupting the natural human gut micro biome.
2) Always throw away antibiotics that are left over from a previous bacterial illness. Using a few doses during a subsequent illness without a full course of treatment is a recipe for training resistant bugs.
3) Stay current with treatment trends. For example, 60-70% of children over the age of 2 years will clear a bacterial ear infection without antibiotics. Viral upper respiratory infections can last for a few weeks. Discuss these issues with your provider. Ask your provider to check for strep throat via a rapid test. Guessing at this disease has been proven to be poor even in great clinicians hands.
4) Be careful with non-pediatric professionals and prescribing habits. We find that overuse of antibiotics is still rampant in rapid/fast/urgent care type venues. Conventional wisdom is to provide some treatment to keep the consumer happy. This is unfortunately bad for this same person in the long run. Short term happiness traded for long term disease risk.
5) Do not be afraid to ask the provider whether the antibiotics are necessary or can a period of watchful waiting be employed with antibiotics on hand in case of worsening. It is your child's health we are talking about.
6) Wash your hands frequently, but especially in any healthcare or food preparation setting.
7) Try and purchase animal meats that are produced without the use of antibiotics in the feed or for non illness related uses. Use your buying power to sway the consumer market.
8) Raise awareness among the people in your circle to these issues. Spreading the work will help save many lives.