Antibiotic Stewardship | Paul Green | TEDxErie

Summary

The script discusses the overuse and misuse of antibiotics, comparing it to buying a car you might not qualify for. It highlights the dangers of prescribing antibiotics unnecessarily, such as increased bacterial resistance. Despite their life-saving properties, antibiotics are often given when not needed, especially for viral infections. This misuse leads to resistant bacteria, making treatments less effective. The script calls for 'antimicrobial stewardship'—ensuring antibiotics are only used appropriately, in the correct dosage and duration, to prevent further resistance and safeguard public health.

Takeaways

• 🚗 The script compares the inappropriate use of antibiotics to being sold a car that may not be suitable for the buyer, drawing parallels between health decisions and poor consumer choices.
• 📈 Over-prescription of antibiotics is a growing problem, with 90% of doctors admitting to prescribing them even when unnecessary.
• 🦠 Antibiotics are being misused, particularly against viruses like the common cold or flu, which antibiotics cannot treat.
• 💊 The overuse of antibiotics is leading to antibiotic resistance, making it harder to treat infections and causing 'superbugs'.
• 📉 The production of new antibiotics has slowed dramatically, dropping from 4 per year to 1 every two years over the past 35 years.
• ⚠️ Antibiotic misuse leads to 2 million resistant infections and 23,000 deaths annually in the U.S., along with $20 billion in extra healthcare costs.
• 🔬 Antimicrobial stewardship aims to ensure antibiotics are used properly, with the right drug, dose, and duration, to reduce resistance.
• 👩‍⚕️ Patients should actively discuss with their healthcare providers whether they need antibiotics, especially for conditions that may resolve without them.
• 🧪 Doctors need to perform tests to ensure the right antibiotic is prescribed for the correct type of infection.
• 🤝 Patients should avoid pressuring healthcare providers into prescribing antibiotics and focus on shorter, more effective treatments when appropriate.

Q & A

What is the main issue being discussed in the transcript?

The transcript discusses the overuse and misuse of antibiotics in healthcare, particularly the pressure on healthcare providers to prescribe antibiotics even when they are unnecessary, leading to antibiotic resistance.

Why are antibiotics often prescribed even when they are not needed?

Doctors often prescribe antibiotics because patients expect a tangible treatment for their illness, and providers feel pressure to meet these expectations. In some cases, antibiotics are given even when the provider suspects a viral infection, which antibiotics cannot treat.

What are the consequences of overprescribing antibiotics?

Overprescribing antibiotics contributes to antibiotic resistance, where bacteria evolve to become resistant to the drugs. This leads to infections that are harder to treat, resulting in more expensive healthcare, increased mortality, and the rise of 'superbugs.'

How many courses of antibiotics are prescribed in the United States each year, and how many are unnecessary?

Approximately 260 million courses of antibiotics are prescribed each year in the United States, and one out of every three of these is either inappropriate or completely unnecessary.

What did Sir Alexander Fleming warn about regarding antibiotics?

Sir Alexander Fleming, the discoverer of penicillin, warned that overuse of antibiotics would lead to bacteria becoming resistant. He predicted that people would start asking for antibiotics even when they don’t need them, leading to a scenario where antibiotics would eventually lose their effectiveness.

What is 'antimicrobial stewardship,' and why is it important?

Antimicrobial stewardship is the practice of using antibiotics responsibly—ensuring that they are only prescribed when necessary, at the correct dose, and for the shortest duration needed. This helps prevent antibiotic resistance and preserves the effectiveness of these life-saving drugs.

Why is it difficult for pharmaceutical companies to develop new antibiotics?

Developing new antibiotics takes a long time—often up to a decade—and is not very profitable because antibiotics are only used for short periods, unlike drugs for chronic conditions. Additionally, new antibiotics are often reserved for the most serious cases to prevent resistance.

What are some of the infections for which antibiotics are often prescribed unnecessarily?

Antibiotics are often unnecessarily prescribed for viral infections such as the common cold or flu, as well as minor bacterial infections like ear infections or bronchitis, which can sometimes resolve on their own without antibiotic treatment.

What steps can patients take to avoid unnecessary antibiotic prescriptions?

Patients should have open conversations with their healthcare providers about whether they truly need antibiotics, consider 'watchful waiting' to see if they recover without them, and ask for tests to confirm a bacterial infection before starting antibiotics.

How can healthcare providers ensure they are prescribing the right antibiotics?

Healthcare providers should collect cultures to identify the specific bacteria causing an infection and test which antibiotics are most effective. They should also tailor the dose and duration of the antibiotic treatment to the patient’s needs, considering factors like organ function and other medications.