A representative of the Centers for Disease Control spoke to Montezuma County doctors on Wednesday about how to better use antibiotics to treat diseases.
Katherine Fleming-Dutra, a pediatric emergency room physician and medical epidemiologist who works with the CDC’s Office of Antibiotic Stewardship, spoke to roughly 50 doctors, nurses and other medical workers at the Sunflower Theatre as part of a series of lectures on antibiotics. Antibiotics are effective as part of outpatient treatment for many diseases, she said, but they can also cause their own problems if overused.
Marc Meyer, a Cortez pharmacist and infection preventionist who has been part of a push to update hospital and clinic guidelines for antibiotics prescriptions, helped organize the event, which was sponsored by Southwest Health Systems.
According to a 2013 report by the CDC, more than 2 million people in the U.S. get sick from antibiotic-resistant bacteria every year, and about 23,000 die from those diseases. Fleming-Dutra said doctors across the country often prescribe antibiotics when they aren’t needed, which adds to the problem. For example, she said that about 10 percent of U.S. antibiotic prescriptions are for bronchitis and upper respiratory infections, which usually don’t require antibiotics at all.
“(This is) a very clear target for us to go after, to improve prescribing or eliminate prescribing for those viral conditions,” she said.
Some doctors overprescribe antibiotics through force of habit or because they’re afraid of leaving a disease untreated, Fleming-Dutra said. But the CDC report showed that pressure from patients also comes into play. Many doctors believe their patients want antibiotics, so they prescribe them even if they’re unnecessary. Fleming-Dutra said it’s important for patients to “ask for the right treatment” rather than assume they need a specific type of medicine.
Antibiotics are necessary to treat many conditions, and Fleming-Dutra said they are even under-used for some, like sexually transmitted diseases. But they can also cause serious side effects in some patients, so the CDC recommends doctors prescribe them only when absolutely necessary. The latest CDC guidelines call for clinicians to track and report the number of antibiotics they prescribe, and educate both medical staff and the public on when it’s appropriate to prescribe antibiotics.
Fleming-Dutra praised Southwest Memorial Hospital for its efforts to improve antibiotic stewardship. Since 2014, the hospital has been involved with national efforts to improve antibiotic prescription habits in local health care providers. Meyer, in particular, has partnered with the CDC to help update their prescription guidelines, and he said they often call him for counsel on how to apply those guidelines to hospitals in small communities.
In his introduction before the talk, Meyer talked about the hospital’s latest efforts in antibiotic stewardship. They started putting greater emphasis on the CDC guidelines in April of 2016, and other health care providers in Montezuma County have updated their practices as well, including dental offices and nursing homes. Now Southwest plans to launch a new project within the next few weeks, in conjunction with St. Mary’s Hospital and Regional Medical Center in Grand Junction, that will look at regional data about antibiotic prescriptions for upper respiratory infections and urinary tract infections. Those conditions account for many of the unnecessary prescriptions nationwide, so Meyer said they’re a good place to start in deciding whether local doctors need to change their approach.
“We’re seeing more and more resistant bacteria in this region,” Meyer said.
The project will compare data on prescriptions in 2016 with 2017 data, to see if the new guidelines are making a difference.
Fleming-Dutra’s talk was part of a series of lectures that started in November, when a doctor from Children’s Hospital in Denver spoke to local providers about antibiotic treatments for long-term pediatric patients. Meyer said the hospital has invited another expert to speak in September on the use of antibiotics in wound care, and they have several other lectures and training courses planned for staff throughout the summer.