Improving diagnostics could help curb problem, experts say
WebMD News from HealthDay
By Tara Haelle
HealthDay Reporter
TUESDAY, Oct. 7, 2014 (HealthDay News) -- About half of all U.S. hospital patients receive antibiotics, and these drugs are commonly the ones more likely to promote the growth of antibiotic-resistant bacteria, a new study found.
"This is where the bad bugs spread, in the hospitals, because so many people are receiving antibiotics, and one of the only things that can spread are the antibiotic-resistant bugs," said Dr. Eli Perencevich, an infectious disease epidemiologist at the University of Iowa Carver College of Medicine.
"We have to figure out better ways to reduce excess antibiotic use, and one way to do that is to get better at making diagnoses," he added.
The study identified how many of more than 11,000 patients received antibiotics on a given day at one of 183 hospitals throughout the United States in 2011. The researchers found that 50 percent of these patients got at least one antibiotic, and about half of those patients received two or more antibiotics.
The study, led by researchers at the U.S. Centers for Disease Control and Prevention, was published in the Oct. 7 issue of the Journal of the American Medical Association. The CDC also funded the study.
The most common reasons for the antibiotics were lower respiratory tract infections, followed by urinary tract infections and skin or soft tissue infections. About 76 percent of the patients received antibiotics to treat infections, and about 19 percent received them to reduce the risk of infection during surgeries, the study found.
More problematic, however, was that the most commonly used medications were broad-spectrum antibiotics, likely due to "fear of targeting the wrong pathogen or missing a resistant organism, especially in a sick patient," said Dr. Mary Anne Jackson, director of infectious diseases at Children's Mercy Hospital and Clinics in Kansas City, Mo.
"There are good bacteria, such as on our skin and in our mouth and intestine, that are normal and vital to keeping us healthy," Jackson said. An infection, on the other hand, is caused by pathogens, the "bad" bacteria. While narrow-spectrum antibiotics primarily target specific germs -- mostly the harmful ones -- broad-spectrum antibiotics go after a broader range of bacteria, which can kill helpful bacteria as well.
It's the broad-spectrum antibiotics, Perencevich added, that are thought to increase the risk of a patient developing an infection caused by bacteria that is resistant to most antibiotics.
"In general, it's better to have someone on a narrow-spectrum antibiotic that treats the specific bacteria causing the infection," he said. But that is difficult to do, he added, if doctors are unsure what is causing a patient's infection or other symptoms.
Dr. Shelley Magill, of the CDC's Division of Healthcare Quality Promotion, was particularly concerned to see that broad-spectrum drugs and drugs that treat resistant bacteria were often used for patients outside of intensive care units and for community-onset infections -- not the most critically ill patients.
source : Hospitals' High Antibiotic Use May Boost Germs' Resistance: Study
