“There is a war going on between us and germs,” says Julius Krevans, Jr. M.D., Medical Director of MDI Hospital’s emergency department. This war, which has been called one of the world’s most pressing public health issues, pits scientists, healthcare providers, and their patients against germs that can mutate and become resistant to what has, for over 50 years, been the first line of defense – antibiotics.
Since their introduction in the 1940s, antibiotics have helped control the spread of infectious disease by killing bacteria that trigger illness. But bacteria, because they are simple organisms, can easily adapt and become resistant to antibiotics. And as antibiotic usage has become more widespread, bacteria have become more resistant.
A significant reason for the increase in resistant bacteria has been over-prescription. “Historically, some providers have prescribed antibiotics because their patients want them, not necessarily because they’re indicated,” explains Dr. Krevans. Bacteria’s ability to adapt easily, combined with a history of over prescription, has increased the number of resistant bacteria.
Fortunately, many institutions like MDI Hospital have systems and procedures in place to ensure the appropriate prescription of antibiotics.
At MDI Hospital, two committees oversee the safe, therapeutic and effective prescription of medications. Hospital personnel also review the latest information on appropriate antibiotic prescriptions on a case-by-case basis. “The emergency department conducts case reviews to address best practices, as well,” adds Dr. Krevans.
Patients often assume that an antibiotic is called for when, in fact, it is not. Certain kinds of infections, including colds, the flu, and most coughs and bronchitis are caused by viruses which should not be treated with antibiotics.
“By doing more education with our providers, patients are also getting the message that we will only prescribe antibiotics when they are called for,” states Dr. Krevans. “If antibiotics are clearly going to make you better, we prescribe them. But if there is little or no chance of the antibiotic helping, there is a definite downside for the patient, and the community.”
Another cause of the growth in resistant bacteria is misuse of antibiotics by the patient. “When you take an antibiotic, it is important that you take them as prescribed,” explains Dr. Krevans. “Do not skip doses, and complete the prescribed course of treatment, even if you’re feeling better,” he emphasizes. “If you don’t take enough to kill the germ, stronger, more resistant germs will survive.”
Dr. Krevans also recommends against saving antibiotics for the next time you are sick, or taking antibiotics that are prescribed for someone else. “Taking the wrong medicine may delay the appropriate treatment and allow bacteria to multiply.”
The consequences of the growth of resistant bacteria are severe. “Illnesses last longer, the risk of complications and death increase, and the cost of care increases,” explains Dr. Krevans. “And with the emergence of superbugs that are resistant to a variety of drugs, the stakes are high.”
Dr. Krevans emphasizes that the war against germs must be fought on several fronts. “Patients must follow the advice and instructions of their providers, and providers must also be vigilant. It is imperative that we all be part of the fight.”