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THE SCIENCES MIND HEALTH TECH SUSTAINABILITY EDUCATION VIDEO PODCASTS BLOGS STORE
MEDICINE
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Microscopic view of staphylococcus, a group of bacteria that can become resistant to certain
antibiotics and cause serious or fatal infections. Credit: Stocktrek Getty Images
If there were a battle hymn against antibiotic resistance, it would have one Supercharged Tuberculosis,
Made in India
common refrain: Every inappropriate prescription or insufficient dose
strengthens the enemy. It may kill weak bacteria but it wont eliminate
stronger, drug-resistant ones that can move in and multiply. Eventually
those robust microbes can outsmart available drugs, and even pass on The viruses that spread
survival instructions to other bacterial strains.Thats why most doctors antibiotic resistance
along with the World Health Organization and the U.S. Centers for
Disease Control and Preventionurge patients to always complete
prescribed drug courses, even after they feel better. Taking too small a
dose or stopping early, they reason, could fuel surges in drug resistance.
Yet the authors are not just calling for more studies that might lead to
shorter standard treatment courses. They are saying that in the short-term
the always complete the course message should be dumped. Research
is needed to determine the most appropriate simple alternative messages,
such as stop when you feel better, they wrote. They assert that there is
also no evidence strong enough to support many of the current guidelines,
a situation that forces physicians to rely on assumptions or historical
practice to decide antibiotic treatment.
Llewelyn and his co-authors suggest some specific steps for the path
forward. They wrote that a common practice in hospitalsa daily review of
a patients continued need for antibioticsmust become more common in
primary care as well, because that is where some 85 percent of
prescriptions are written. (Many experts, including Hicks, say this
recommendation is probably unrealistic due to the need to pay for follow-
up visits and limitations on both doctors and patients time in an
outpatient setting.) The authors also call for fundamental changes in
public health and drug treatment messaging: Public education about
antibiotics should highlight the fact that antibiotic resistance is primarily
the result of antibiotic overuse and is not prevented by completing a
course, they wrote. Such big changes in messaging are not yet ready for
prime time, Price says.
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