March 19, 2001--
"Don't ask - and don't give!"
That's what two major medical organizations are strongly recommending this week to both patients and doctors who continue overusing antibiotics.
Science Specialist Ed Yeates reports on the new guidelines.
Sore throats, bronchitis, sinusitis and a whole host of other respiratory tract infections. The American College of Physicians and the American Society of Internal Medicine say antibiotics are simply not appropriate for these illnesses anymore without evidence of secondary bacterial infections.
LARRY WRIGHT, M.D., LDS HOSPITAL INFECTIOUS DISEASE SPECIALIST: "LAST YEAR IN OUR LABORATORY, 30 PERCENT OF PNEUMOCOCCUS THAT WE ISOLATED ARE PENCILLIN RESISTANT NOW - AND THAT'S A MAJOR, MAJOR PROBLEM."
LDS Hospital Infectious Disease Specialist Dr. Larry Wright says the pneumococcsi bacteria is more potent now because of the overuse of antibiotics.
For example, a broad spectrum or "shotgun" antibiotic as it's called, may be given at a first visit as a backup to make sure the patient does not develop a secondary bacterial infection.
But what it really does...
DR. WRIGHT: "IT KILLS OFF NORMAL BACTERIA AND ALLOWS YOU TO SELECT OUT MORE RESISTANT ORGANISMS TO BECOME PART OF YOUR NORMAL FLORA - AND THEN IF YOU GET A SUBSEQUENT INFECTION, YOU'RE AT MUCH GREATER RISK."
Dr. Wright says there are rare exceptions where doctors may choose - for example - to treat all forms of bronchitis.
DR. WRIGHT: "IF WE WERE IN THE MIDDLE OF AN OUTBREAK OF PERTUSIS OR WHOOPING COUGH, THAT'S AN EXCEPTION. BUT IN THE ABSENCE OF AN OUTBREAK, THERE IS NO JUSTIFICATION."
The new guidelines offer specific steps for physicians to follow before using an antibiotic. And patients should not demand an antibiotic just because they believe it will work.
ED YEATES, SCIENCE SPECIALIST: "FOR EXAMPLE, ABOUT TWO WEEKS AGO I HAD A BRONCHIAL INFECTION. BUT THE TREATMENT OF CHOICE IS NO LONGER AN ANTIBIOTIC BUT A BRONCHIAL INHALER MUCH LIKE AN ASTHMATIC USES TO KEEP THE AIRWAYS OPEN. "
Despite the recommendations, Dr. Wright says some pharmaceutical salesmen are still encouraging use of the broad spectrum antibiotics, mostly to physicians working in rural clinics.
More Info
Details From AP
Annals of Internal Medicine: Article & Guidelines
CDC: Drug Resistance Information
