Antimicrobial Stewardship

When I rolled out of bed at 7 AM for the Antimicrobial Stewardship, I had every intention of just showing up and paying no attention in order to earn the extra credit. To my surprise, I found all of the speakers to be extremely interesting and bringing up points that I had no idea were a problem in our world today. They weren’t just speaking about any tiny problem, but serious issues that are putting our population in danger. The main topic of discussion was that doctors are prescribing antibiotics when they don’t need to be. This got me thinking, why would they give their patient medicine that they know is not going to work. They have been through years and years of schooling to be able to educate their patients and tell them that they will get better without said antibiotic, yet they just hand them the prescription and they are on their way. This was touched upon by one of the speakers, but I wanted to go more in depth to really have an understanding of why educated medical practitioners were prescribing unnecessary antibiotics.

antibioticsA study was funded by Nesta (National Endowment for Science, Technology, and the Arts) to conduct research on the problem of antibiotic resistance. (article) “The survey of 1,000 general practitioners found 90% of respondents felt pressure from patients to prescribe them antibiotics…Nearly half – 45% – of the GPs surveyed said they had prescribed antibiotics for a viral infection, knowing it would not be effective.” This proves that 90% of the doctors surveyed felt that it WAS NOT necessary to give their patients the medication, yet they did it anyway. Also, within the 45%, the doctors could have explained that their virus would not get bet
ter with the medication and refuse to give it to their patients. I realize that it is easier said than done, but this is a serious issue that we are facing.

A study conducted by the National Center of Biotechnology Information looked at the different reasons why doctors would want to prescribe unnecessary antibiotics. An issue that proved difficult was maintaining doctor-patient relationships. “One doctor who described himself as a low prescriber highlighted his difficulties in negotiating with patients who dem
anded antibiotics because they believed in their effectiveness.” Other factors that came into play were clinical experience, delayed prescribing, and their views on antimicrobial resistance.

The University of Virginia gives advice about asking your doctor of antibiotics. They state that “In general, it is best not to ask your doctor for an antibiotic. As with any other treatment, physicians are not supposed to give you an antibiotic unless it is needed… There is nothing wrong with asking questions, but listen to what your physician has to say.” They go on to explain how serious of a problem is it to take antibiotics that you do not need. It will not make you get better any faster and it could hurt you detrimentally in the long run.

In conclusion, when you feel sick, you should not immediately expect to be given an antibiotic to feel better.

 

2 thoughts on “Antimicrobial Stewardship

  1. Kendall Nicole Higgins

    This is quite interesting. I didn’t make it to the extra credit opportunity, but that’s cool to hear it was enjoyable for the people who did. I’ve never heard of this issue with antibiotics before but it doesn’t surprise me. It makes me think of the idea of experimenter bias except in this situation it is patient bias. The patient believes that he/she is sick, so he/she believes he/she deserves the antibiotic. It reminds me of the time we talked about ethical and unethical trials in class. People are so desperately concerned for their health that they will do anything to get the medicine they think will help them…..even if no one is for sure that it does. Who can blame them for caring so deeply about their health or the health of their loved ones? It disappoints me to hear that doctors who know better prescribe these medications to clients in fear of jeopardizing their relationship with their client, but I could see how it is easier to simply give the patient what he/she wants. It’s like what Andrew said in class that it is difficult to convince a public as humans intuition is lousy. We think we need these drugs because we think they will help us but they actually don’t and we don’t want to listen to any doctor who tells us otherwise.

  2. Daniel Liam Cavanaugh

    This was a very relevant topic to choose after a lot of us went to the extra credit opportunity. I agree that the lectures on antibiotic use were a lot more engaging than I’d expected. Your point about doctors giving antibiotics to patients I think has a lot to do with the pressure that they get from patients to prescribe them. In the Hub, a great example of this was the guy they mentioned who was contemplating retirement after all the pressure he’s received for not giving antibiotics to students who don’t need them. Sitting through the antibiotic talk and reading this blog has made me realize how ignorant so many of us are when it comes to medication. We should be listening to our doctors, the people who based off of their years of experience, know what they’re talking about. You have a lot of directions that you can take for your next blog based off of this one. A couple examples would be to analyze the negative effects of antibiotics on different age groups or to write a post about the evolving bacteria that are fighting back. Here’s a source on the former topic.
    http://www.sciencedirect.com/science/article/pii/S0002927099008084

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