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CDC Campaign Hasn’t Slowed Inappropriate Antibiotic Use

issue brief 2011 02 coverHigh rates of inappropriate antibiotic use continued despite a 15-year campaign by the Centers for Disease Control and Prevention (CDC) aimed at Michigan physicians and consumers on the dangers of antibiotic overuse.

The Center for Healthcare Research & Transformation (CHRT) released an issue brief detailing overall antibiotic prescribing for adult Blue Cross Blue Shield of Michigan (BCBSM) members. (The project is a non-profit partnership between the University of Michigan and BCBSM.)

While antibiotic prescribing in adults decreased 9.3 percent from 2007 to 2009, it increased 4.5 percent for children during the same time period. The studies found significant differences in prescribing patterns between rural southeast Michigan and the rest of the state, particularly for children. Children in rural southeastern Michigan were prescribed an average of .93 antibiotics per year, while elsewhere children were prescribed an average of 1.0 per year.

“The continuing high rate of antibiotic use for viral infections in children and adults — particularly outside of southeast Michigan — is of great concern, as is the increase in the use of broad spectrum antibiotics in children,” said Marianne Udow-Phillips, CHRT’s director. “Using antibiotics when they are unnecessary — or treating simple infections with drugs that should be reserved for the most serious infections — are practices that contribute to antibiotic resistance, making future infections harder to treat.”

Nearly half (49.1 percent) of antibiotic prescriptions in the study population were for broad spectrum antibiotics in 2009, compared to the national rate of 47 percent. Between 2007 and 2009, prescriptions for what the National Committee for Quality Assurance calls “antibiotics of concern” declined slightly in adults, decreasing 0.4 percent during that time period. In the same time period, antibiotics of concern prescribed to children increased 3.4 percent, from 44.9 percent to 46.4 percent.

One possible explanation for the rising rate in children is a rise in resistant pathogens in ear infections, according to the study brief. Other possible reasons are that kids get different infections than adults, and that some drugs that are used in adults are not used for pediatric patients. Read more »

*This blog post was originally published at ACP Internist*

Developing New Antibiotics: Thinking Beyond Bacteria Resistance

44s3uqhhro.jpgBacteria may be having a renaissance. Back in the days of the discovery of penicillin, doctors gleefully handed out antibiotics like they were candy and patients were more than happy to munch them down. They were quite effective too, but bacteria rapidly became resistant.

Doctors and scientists worry that we are approaching a time where if we don’t come up with novel antibiotic mechanisms, we will face an epidemic of untreatable bacterial infections. MRSA, methicillin-resistant staphylcoccal auerus, is probably one of the biggest fears.

John Rennie wrote about this issue in the PLoS blog The Gleaming Retort. He describes two strategies scientists are using to try to come up with new weapons in the great antibacterial war. So, naturally one of the first things they turned to was cockroach brains. Read more »

*This blog post was originally published at Medgadget*

Overtreatment: When Less Is More In Medicine

The Associated Press recent article “Overtreated: More medical care isn’t always better” reiterated a commonly known fact which is not understood by the public. This problem of doing more and yet getting little in return is a common issue which plagues the U.S. healthcare system and was illustrated quite convincingly by Shannon Brownlee’s book. Americans get more procedures, interventions, imaging, and tests but aren’t any healthier.

In fact they are often worse off. Too many unnecessary back surgeries. Too many antibiotics for viral infections, which aren’t at all impacted by these anti-bacterial therapies. Too many heart stents which typically are best used when someone is actually having a heart attack. Research shows that those that are treated with medications do just as well. As all patients with cardiac stents know, they also need to be on the same medications as well.

Eliminating unnecessary treatments is a good thing, particularly when it is based on science. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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