Use of Antibiotics

Dr. M. Vijayalakshmi, M.D (Peds), M.D (USA), F.A.A.P

"Data Courtesy: Articles in Medical Journals about Antibiotic Resistance"
Antibiotic Resistance

Medicines used to fight infections caused by bacteria are known as antibiotics. Within a short time, bacteria became resistant to antibiotics that were previously effective. Over the decades, bacteria have continued to become resistant to antibiotics, despite the introduction of new, and stronger medicines.

Antibiotic resistance has been called one of the world's most pressing public health problems. And organizations such as the Centers for Disease Control and Prevention have undertaken efforts to educate physicians and the public about antibiotic resistance. Confirming a bacterial infection, selecting the appropriate antibiotic for an infection and educating patients about the importance of taking therapy exactly as prescribed are considered areas for improvement needed.

Bacteria can become resistant in several different ways, all of which involve changes in their genetic material, or genes. These altered genes enable the bacteria to either destroy the antibiotic or otherwise block its ability to inhibit bacterial growth. The laws of natural selection suggest that all bacteria will eventually become resistant to antibiotics at some point. Repeated and improper use of antibiotics are two of the main causes of the increase in resistant bacteria.

Common Reasons for Over prescribing of Antibiotics

It is estimated that up to 50 percent of antibiotic prescriptions given in community settings are not needed. Common factors that contribute to antibiotics being prescribed inappropriately include:

  • Patient request for an antibiotic
  • Physician perception that the patient expects an antibiotic
  • Limited time to confirm an accurate diagnosis or explain to the patient why an antibiotic is unnecessary
  • Concerns about misdiagnosing bacterial infections as viral
Patient Influence on Resistance

Patients may contribute to resistance by requesting or demanding an antibiotic even if they do not have a bacterial infection. Patient noncompliance may also contribute to antibiotic resistance and has become a significant patient safety concern. A complete course of antibiotics is needed to kill all of the harmful bacterial. An incomplete course of antibiotics often wipes out only the most vulnerable bacteria, which allows relatively resistant bacteria to survive and thrive. Common ways patients don't comply with therapy include:

  • Fail to buy medicines or fill the prescription
  • Fail or delay start of medicine intake
  • Skip doses
  • Take extra doses early in treatment
  • Stop medication when patient experiences symptom relief, but before completing the full course of treatment

Reasons for noncompliance vary and may be attributed to the medication and its dosing - ie, complexity of the treatment regimen (frequency and duration of doses), side effects or patient behavior.

Patient noncompliance can encourage the growth of resistant bacteria. The infections caused by these stronger bacteria are harder to cure - patients stay sicker for a longer time, and the infections become more costly to treat. Noncompliance has been associated with treatment failure, deterioration of patients' health, additional doctor visits, use of supplementary drugs, additional hospital admissions and increases in medical costs.

Remember, there is no substitute for medical advice that comes from a pediatrician after they have evaluated your child. This document is only for informational purposes and is not a substitute for medical advice.