All those antibiotics you have taken over the years for coughs and sore throats could make you more susceptible to a deadly superbug a federal agency recently warned kills tens of thousands of people a year.
A deadly bacterium called clostridium difficile infects nearly 500,000 and kills nearly 30,000 people a year, according to figures released earlier this week from the U.S. Centers for Disease Control and Prevention.
A leading cause of the drug-resistant superbug is something used to actually kill bacteria: antibiotics. More specifically, lots of antibiotics.
An antibiotic will kill the bacteria susceptible to the drug, but also leave behind microbes that are resistant to that particular antibiotic. The more antibiotics a person takes, the more microbes build up in the body, the CDC has said. That can make difficult superbugs harder to kill due to built-up resistance to antibiotics.
The CDC has known about the issue for some time and has done a lot to educate physicians and patients about the dangers of over-prescribing. However, experts say they can’t do much more.
All the agency can do is “try to educate patients and doctors about the problem,” Dr. Mark Ebell, an epidemiology professor at the University of Georgia, told the Washington Examiner. “Ultimately it is up to the individual physicians and their patients to work on this.”
But physicians at times face pressure from patients, whether real or perceived, to provide an antibiotic, said Dr. Matthew Kronman, assistant professor of pediatric infectious disease at the University of Washington.
Kronman performed a study that found 11.4 million unnecessary antibiotics are prescribed to children and teens each year in the U.S.
A parent could either come in and want an antibiotic for his or her child no matter what, or the doctor could incorrectly perceive that the parent wants an antibiotic when in fact he doesn’t, Kronman said.
To solve the dilemma, Kronman pointed to research that suggested doctors emphasize the treatments they are providing versus the ones that aren’t necessary. For instance, a doctor should tell a parent to give the sick child a fever reducer or drink lots of liquids, not come out first and say that they don’t need an antibiotic.
Some physicians also lack rapid diagnostic tests to determine if no antibiotics are needed, said Amanda Jezek, vice president of public policy and government relations for the Infectious Disease Society of America.
The most commonly overprescribed ailment is a cough, described as “acute bronchitis,” Ebell said. The vast majority of these patients have an infection caused by a virus, and “antibiotics don’t kill viruses,” he added.
Ebell said people should be patient if there is a cough in their chest. That cough, called a “chest cold,” is almost always viral and takes about two weeks to fully recover, he said.
However, if you are short of breath, cough up blood, have chronic lung disease or are worried then see a doctor, Ebell added.
Jezek said the administration could take steps to improve prescribing practices in hospitals. The U.S. Centers for Medicare and Medicaid Services could make setting up an antibiotics stewardship plan a condition of participation in Medicare. To get reimbursements, a hospital would have to create a program that oversees how antibiotics are prescribed and managed.
However, CMS has not proposed such a condition and the agency did not immediately have a comment.
While stewardship programs are helpful for hospitals, Jezek conceded that the solution wouldn’t work for independent doctors’ offices.
However, agencies could audit prescribing practices and give doctors a report on what they prescribed over a period of time, Kronman said. That could help show doctors the amount of antibiotics they have prescribed and why they might need to cut back.
President Obama devoted $1.2 billion in his fiscal 2016 budget request to CDC to help address the issue.
