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| Hpathy Ezine - Feb., 2004 | ||||
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Passing The Buck -- Barbara M. |
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In September of 2003 the CDC relaunched a program originally introduced in 1995 called "Get Smart, Know When antibiotics work." This is a 1.6 million dollar campaign targeted towards physicians and patients to educate them on the proper use of antibiotics. The purpose of this campaign is to reduce the amount of inappropriately prescribed antibiotics in the hope of reducing the increase of antibiotic resistant microbes. According to the CDC virtually all important bacterial infections currently have resistant strains, making resistant bacteria a crisis in the US and throughout the world. In 1995 The AMA studied the issue of resistance and released the following statement: "The global increase in resistance to antimicrobial drugs, including the emergence of bacterial strains that are resistant to all available antibacterial agents, has created a public health problem of potentially crisis proportions." Reports on antibiotic usage in the United States vary but estimates put the numbers of antibiotic prescriptions written in the US at anywhere from 100 to 250 million. According to Dr. Richard Besser of the CDC there are currently tens of millions of unnecessary antibiotics prescribed annually. The CDC reports that 90% of all upper respiratory infections, including children's ear infections, are viral yet URI account for 70% of all antibiotic prescriptions written. It is also estimated that 41 million antibiotics are written for the common cold annually. That comes to about $1.1 billion spent on antibiotics just for cold viruses. There are about 7 million adult annual visits to the physician for sore throats each year. Of these visits 90% are for viral infections and yet 74% of these visits result in an antibiotic prescription, typically a broad-spectrum antibiotic. Unfortunately, of the some 40 million patients hospitalized each year nearly 2 million of them will develop a nosocomial infection and about 60% of these infections will involve antibiotic resistant microbes. There are approximately 60,000 - 70,000 deaths per year from nosocomial infections. The annual financial cost of antibiotic resistance in the US alone is 30 billion dollars. These are staggering numbers. It seems fair to say that somewhere, someone is responsible for such irresponsible prescribing, but whom? According to the CDC, the AMA and several state health organizations the blame falls to the patients and parents of the patients. In fact when doing a "Google" search on antibiotic resistance for this article almost all searches returned some references to patients demanding antibiotics from their physicians. It is common phrasing that "patient demand" for antibiotics is the cause of inappropriate antibiotic usage. One hospitals website goes so far as to describe patients as "strong-arming doctors" for antibiotics. Rarely, if ever, is the responsibility focused on the physicians or medical organizations that regulate physicians' standard of care. I am of the opinion that this is the ultimate scapegoat strategy. I have strong doubts some 100 million patients are storming their doctor's offices "demanding" to be given an antibiotic for a viral condition. In fact, I think most of us are rather intimidated by our physicians and their starched white coats. Studies involving patient satisfaction often indicate that one of the main complaints patients have with their physicians is that they feel their doctors don't listen to them. We are all familiar with the catch phrase "god-complex" and know that it refers to physicians feeling superior and certainly not subject to the "strong-arming" of their patients. Just try disagreeing with your doctor about treatment methods and you will quickly realize they are not being "strong-armed" by the patients about anything. |
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