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6 Ways To Avoid Antibiotic Overuse

Antibiotics can save lives but overuse poses a serious threat to the human body.

Vail Valley Medical Center collaborated with seven Colorado hospitals on a two-year study which followed 533 children and adults hospitalized for soft tissue infections.

It was one of four major recent studies VVMC contributed to by measuring antibiotic prescription practices in both rural and metropolitan Colorado regions evaluating how the state is doing overall.

The research strongly indicated doctors are consistently overprescribing antibiotics that are too strong for specific bacterial infections and patients are taking them for too many days according to Jason Moore PhD an epidemiologist at VVMC.

Through a comparison of wound and skin cultures the 533-patient study demonstrated that specific bacteria cultured could often have been effectively treated with a less potent antibiotic Moore says.

The study which ended in 2012 empowers both patients and physicians to be more cautious when it comes to antibiotic prescriptions.

“VVMC's vision for excellence in specialized care is realized through important studies like this” explains the hospital's President and CEO Doris Kirchner. “Our goal is to continue to collaborate with leading researchers to produce evidence-based practices that benefit our patients here in Eagle County and beyond.”

How to handle antibiotics

1. Get educated
The first step Moore says involves educating the general public about how antibiotics are overprescribed and the danger of such practice.
Antibiotics are the most common drugs doctors prescribe according to the Centers for Disease Control. While they can save lives overuse can lead to harmful antibiotic-resistant bacteria.

Antibiotic resistance occurs when antibiotics kill both good and bad bacteria but drug-resistant bacteria remain alive and are able to multiply. Then some bacteria pass on their drug-resistance to other bacteria which cause more infection. These ultra-resilient “bugs” pass from person to person and they also can remain on improperly cooked or handled animal meat and crops.

Nationally antibiotic resistant bacteria are responsible for at least 2 million illnesses and 23000 deaths annually.

Still patients often visit doctors with the expectation of an antibiotic prescription Moore says.

2. Trust that sometimes you do not need antibiotics
“We need to instill realistic expectations in patients” Moore says “and figure out which disease needs antibiotics. Sometimes no antibiotics (are indicated).”

He says one of the reasons doctors overprescribe antibiotics has to do with patient expectation and pressure. Another involves training.

“A lot of us are taught to be worried about (deadly illnesses) so we (sometimes) jump to the worst-case scenario” he says explaining why busy doctors also might overprescribe.

3. Communicate with your doctor
He encourages a stronger collaborative partnership between patients and doctors. For example patients should return to the same doctor if they don't feel better after the first visit. Instead they often see another physician rather than scheduling a follow-up.

“Communication is the cornerstone of every relationship especially in this case” he says. “Patients should come to the doors with open ears and it goes the other way too there's a responsibility for doctors not to succumb to the pressure of prescribing an antibiotic.

4. Ask questions
“Patients should ask providers 'Does this really need an antibiotic?' versus asking for one. I think that's the most responsible action” he says.

Of course if an ailment including a respiratory illness for which many patients request antibiotics worsens rather than improves antibiotics may be necessary.

5. Hydrate and pay attention to your symptoms
One rule of thumb involves remaining hydrated if patients can't tolerate liquids it's time to see a doctor. Most viral illnesses slowly get better or stay about the same within 24-48 hours after which a person may “feel or stay crummy” Moore says but does not rapidly decline. On the other hand serious bacterial infections can take a turn for the worst in a matter of hours or days.

“If symptoms progress or worsen it needs to be seen” Moore says.

6. Ask about hospital antibiotic policies
VVMC helps patients navigate the often confusing process of dealing with disease not only through doctor visits but also through the hospital's Antibiotic Stewardship Program which includes a multidisciplinary medical team that follows patients' progress and identifies best practices.

Moore helped VVMC stay ahead of the curve by helping launch the Antibiotic Stewardship Program about a year and a half ago. It consists of pharmacists physicians epidemiologists and other healthcare professionals who track the suitability of specific antibiotics and make changes as necessary while patients are in the hospital.

“Patients can be assured that when they're being treated they truly have a multidisciplinary team in real time as they're in this hospital” Moore says.

The recent antibiotic studies support this concentrated multidisciplinary approach but it's only one important aspect in which VVMC has led the way. Moore has researched traumatic ski and snowboard injuries and more.

He believes in proactive local clinical research rather than “waiting for the next big paper to come out to show us how to care for people.”

“From a community hospital perspective it's on us to do active research” he says. “Until we know where we are we don't know where we want to go. We need to identify what we're doing right and wrong. The end beneficiary of this is the patient it directly contributes to improved patient care and patient outcomes.”