The last time I needed antibiotics, I toughed it out for days before seeing a doctor, by which point my pain had gotten so bad I couldn't sleep through the night. The reason? I didn't want to be a vector for the next superbug. By the time I did get medical help, the doctor reassured me in the worst way possible: “Honey, it’s too late for that," she said. "You are not going to be the reason for the next superbug.”
The cause of the next superbug will probably not be a single individual trying desperately to avoid that outcome. It'll be our whole antibiotic-loving healthcare system: According to a new report, around 30% of antibiotics prescribed are actually unnecessary and just make the whole situation worse.
The researchers, in a joint project between the CDC and the Pew Charitable Trusts, published in JAMA, combed through the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to find appointments that resulted in antibiotic prescriptions. They then cross-referenced each diagnosis with the prescription guidelines for that condition. (For diagnoses whose guidelines were on the fence about whether or not antibiotics are appropriate, the researchers compared overall prescribing patterns with the region that prescribes the fewest antibiotics for that diagnosis to come up with a guideline.)
Of the 184,032 medical visits surveyed, 12.6% resulted in an antibiotic prescription. And of that 12.6%, nearly a third were unnecessary. That's around $3 billion wasted annually on antibiotics that won't do anything but fuel resistance.
As most people hopefully know by now, antibiotics only work on bacterial infections. If you don't take the whole course of antibiotics, you won't kill off all the bacteria, thus allowing the fittest to survive and creating the next superbug. If you take them for a viral infection, you'll bombard your body with medicines that have no effect on your sickness, ensuring that the non-culpable bacteria in your body that survive are resistant to that antibiotic, creating the next superbug anyway.
These are basic tips for avoiding the next superbug. Yet still we take antibiotics we don't need, and don't finish courses we do. Conventional wisdom has it that doctors prescribe too many antibiotics (despite knowing better) because it's what patients want.
But according to David Hyun, who runs the Pew Charitable Trusts' Antibiotic Resistance Project, that's simply not the case. "Expectations sometimes can be overperceived," he said on a conference call with reporters yesterday. "There’s a gap between what the patient expectations are and what the physician perceptions are." In other words, doctors overprescribe antibiotics because they think it will make their patients happy. Those patients, on the other hand, are generally willing to do whatever their doctor recommends, whether that's a bottle of pills or just bed rest and Netflix.
That's right, worried patients: It's not you who are the cause of the next superbug. In all likelihood, it's actually your doctor. A recommendation of just-in-case antibiotics can be awfully tempting for a patient in the throes of a nasty sinus infection. But stay strong and ask if that's really the best course of action--that's all it takes to fight back against bacteria we really can't treat.
