New antibiotics must be used wisely

Adults, Physicians and Others Urged To Help Control Antibiotic Resistance

The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) reacted to the recent FDA approvals of two new antibiotic drugs with both praise and caution. "ACP-ASIM members -- internists or specialists in adult health -- have watched with alarm as some bacteria and other disease-causing agents have become resistant to many, and in some cases all, antibiotics," said Herbert Waxman, MD, ACP-ASIM senior vice president for education. As a result, on April 14, 2000, ACP-ASIM launched a campaign to actively work to reduce antibiotic resistance. "New antibiotics are definitely welcome and needed," Waxman said, "but we must use these new drugs wisely, or they too will become ineffective in treating infections."

"Bacteria mutate," Waxman pointed out. "It's their nature. Some of our older antibiotics have become ineffective for reasons under human control: overuse of the drugs; using them for inappropriate illnesses such as colds and flu (which are caused by viruses, not bacteria); overuse of antimicrobials in veterinary practice and food production; and patients not complying with prescribed therapy."

As part of the College's antibiotic resistance campaign, ACP-ASIM released a list of "do's and don'ts" showing how adults, patients, physicians and organizations can help reduce the development and spread of antibiotic-resistant diseases. Among the hints:

Tips for Patients

• Don't insist on antibiotics for yourself or your children. Talk with your doctor about the risks and benefits of antibiotics and which antibiotic is appropriate for your problem.
• Remember, most colds, coughs, sore throats, and runny noses are caused by viruses, not by bacteria. Antibiotics only work against bacteria.
• Don't use antibiotics remaining from old prescriptions without a doctor's instruction. Never share antibiotics with family or friends.
• Wash hands thoroughly and often and teach your children to do the same. Prevent illnesses by eliminating resistant bacteria that may spread to others.
• Make sure your immunizations and your children's immunizations are up-to-date. Immunizations prevent disease. The elderly and those with chronic illnesses, in particular, should seek vaccination against influenza and pneumonia.
• If you are prescribed antibiotics, finish the prescription, even if you feel better. If you don't, some partly resistant bacteria may remain and multiply. The infection may return a few weeks later, but a different--probably stronger drug--must be used to treat it.
• Wash fruits and vegetables thoroughly. Avoid raw eggs and undercooked meats, especially ground meats.

Physicians

• Don't over-prescribe antibiotics.
• Use the most specific, targeted, or "narrow-spectrum" antibiotics possible. Save the broad-spectrum drugs for infections that resist the older drugs.
• Wash hands between each patient visit.
• Educate patients about the risks of antibiotic resistance.
• Make sure that all patients have the appropriate immunizations.

Hospitals

• Improve infection control.
• Use ultraviolet lights; work for better sanitation; insist on more frequent and proper hand washing by staff.
• Identify quickly and isolate patients with drug-resistant infections.

NOTE: For a complete list of ACP-ASIM's "Do's and Don'ts" to help control antibiotic resistance, call 1-800-523-1546. ext. 2656.