Antibiotics have changed the practice of medicine, making once lethal infections readily treatable and making other medical advances, like cancer chemotherapy and organ transplants, possible. The prompt initiation of antibiotics to treat infections has been proven to reduce morbidity and save lives. However a large number antibiotics prescribed are either unnecessary or inappropriate. Like all medications, antibiotics have serious side effects. Patients who are unnecessarily exposed to antibiotics are placed at risk for serious unfavourable events with no clinical benefit. The misuse of antibiotics has also contributed to the growing problem of antibiotic resistance, which has become one of the most serious and growing threats to public health. Unlike other medications, the potential for spread of resistant organisms means that the misuse of antibiotics can negatively impact the health of patients who are not even exposed to them. The Centres for Disease Control and Prevention (CDC) estimates more than two million people are infected with antibiotic-resistant organisms, resulting in approximately 23,000 deaths yearly (1).
Antibiotic stewardship is a coordinated program that promotes the appropriate use of antibiotics to improve patient’s outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Let us look at a case of antibiotic resistance due to the inappropriate use of antibiotics (2).
Lerato is a 20 year old Pharmacy student at Rhodes University. She is actively involved in netball. During a game Lerato began to feel faint and unwell. She was immediately rush to the doctor and she found out she had an infection. She was treated and given a prescription for schedule four antibiotics and was told to come back in a week for a check-up.
Lerato however, was too caught up with her work that she had forgotten to take her medication on certain days. Due to this, the symptoms and outcomes of her infection began to get worse. Lerato was once again rushed to the doctor. Upon inspection, it was concluded that Lerato did not follow her prescribed course as the bacteria responsible for the infection had begun building up resistance to the antibiotics.
Lerato was then given a schedule 5 antibiotic (which is stronger than the previously prescribed) and was told specifically to follow the prescription. As scared as Lerato was, she made sure to follow her prescription and take her antibiotics timeously. Eventually after a long week of being miserable and sick, Lerato was fortunate enough to be cured of her infection.
Fortunately, for Lerato, she was not part of the 23000 deaths that year. However, she could have avoided taking the stronger dose by following her prescription. Choose to Be Smarter than Lerato because you might not be as fortunate as she was. Your life is in your hands! Make the Right Choice!
- Centers for disease control and prevention. Core Elements of Hospital Antibiotic Stewardship Programs. (Updated 2017 February 23; cited 2017 March 30) Available from https://www.cdc.gov/getsmart/healthcare/pdfs/core-elements.pdf.
- Association for professionals in infection control and epidemiology. Antimicrobial stewardship (Updated 2017 February 18; cited 2017 March 30) Available from http://www.apic.org/Professional-Practice/Practice-Resources/Antimicrobial-Stewardship.
- Drawings done by Reshna Nundlal (2017 April 02)