By Maggie Sabay
Nurse Practitioner, Canyon Health and Wellness Clinic
In April 2019, I was privileged to attend a one-week conference focused on training in infection prevention. Because our clinic will be going through a rigorous accreditation in 2020, it was recommended by the Accreditation Association of Ambulatory Healthcare (AAAHC) that one staff person obtain in-depth education about numerous infections and how to prevent them.
During this conference, the topic of “antibiotic stewardship” received much attention. You might be asking: “What is antibiotic stewardship and how does this topic relate to me?”
A very basic definition of antibiotic stewardship is making certain that when an antibiotic is prescribed, the antibiotic is actually needed. Let’s look at the history of antibiotics in the United States and how they have become overused.
Antibiotics were first used during World War II, and their usage increased during the next decades, called the Golden Age of antibiotics. As a result, deaths from infection plummeted and life expectancy increased.
During this time, new antibiotics were being developed; however, it soon was noticed that some antibiotics were no longer effective. This became known as antibiotic resistance.
Simply explained, antibiotic resistance happens when germs such as bacterial and fungi develop the ability to defeat the drugs designed to kill them. This means the germs are not killed and continue to grow, so the next time the antibiotic is used, it is ineffective.
By 2000, it was determined that antibiotic resistance was actually killing patients. According to the Centers for Disease Control and Prevention (CDC), each year in the U.S., at least 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die because no antibiotic can treat the infection!
For the past 20 years, the CDC has been encouraging providers NOT to prescribe antibiotics for viral infections. There have numerous public health campaigns to protect the public against antibiotic resistance, with guidelines emphasizing viral versus bacterial infections.
The CDC wants the public to be educated that colds and flu are viral infections and no antibiotic is needed. (For positive flu tests, an anti-viral will be prescribed.) Sinus infections are generally viral, and the guidelines state that providers should wait 10-14 days before prescribing an antibiotic. Additionally, bronchitis is generally viral, and antibiotics should not be used. This is a change in thinking for many prescribers.
Because of the longstanding overuse of antibiotics, it is not uncommon for many walk-in and urgent care centers to conduct audits of prescribers’ antibiotic usage patterns. Those audits have resulted in a decrease, sometimes by 50%, in the number of antibiotics prescribed.
At the Canyon Health and Wellness Clinic, we are following the newest guidelines provided by the CDC for judicious use of antibiotic prescribing. Our practice is for your protection; you may not be able to get antibiotics every time you want them, but you will be able to get antibiotics when you NEED them!
