November 13-19, 2017 kicks off the U.S. Antibiotics Awareness Week. While antibiotics are life-saving, they do come with risks. Bac-terial resistance to antibiotics is everywhere and the way we utilize antibiotics today will affect patients and how we deliver healthcare in the future. Although some people are at greater risk, no one can avoid the risk of antibiotic-resistant infections. As we all were affected by last year’s devastating fire season that swept across our state, in healthcare we have also been watching antimicrobial resistance as it sweeps across the nation. Antibiotic resistance and its consequences are here in our community with names like MRSA and C diff, and we all have a part to play in protecting our antibiotic resources.
An antibiotic is a type of drug that kills or stops the growth of bacteria. Antibiotics are not effective against viruses such as the common cold and influenza. How antibiotic resistance happens is illustrated below in this Centers for Disease Control and Prevention (CDC) graphic:
Antibiotic resistance is also worsened because of antibiotic prevalence. Antibiotics are among the most commonly prescribed drugs used in healthcare today. Our biggest weapon in fighting bacterial disease (antibiotics) is also the biggest aide in perpetuating resistance. Each year in the United States, at least 2 million people acquire serious infections with bacteria that are resistant to one or more antibiotics. Of those 2 million people, at least 23,000 people die from these complicated infections. Those numbers may seem far-fetched here in our little corner of the Big Sky state, but we are seeing these resistant bacteria here at home as well.
MRSA or methicillin resistant Staphylococcus aureus and Clostridium difficile (C difficile or C diff) have become household names for many Montanans and are currently among the top resistance threats in our state. MRSA is a member of a group coined as “super bugs” due to their impressive ability to survive and change in order to resist antibiotics. Just two short years after the discovery of Methicillin in 1960, strains of methicillin resistant Staph aureus began to emerge globally and are now common in our own community today. C. difficile, is a common issue resulting from antibiotic use. C. difficile is a diarrheal disease often associated with long-term use of antibiotics in elderly patients or in cases of inappropriate use of antibiotics. Misuse of antibiotics can include taking other people’s prescriptions, not following your physician’s instructions and overuse for non-bacterial infections. Antibiotics can wipe out the normal “good” bacteria in our bodies for several months putting us at increased risk for developing C. difficile. C. difficile infections result in 14,000 deaths each year in the U.S.
Resistance is the threat, so what are we doing to stop this wildfire from spreading?
Every patient and every bacterium has the potential of being unique in either its identification or its response to antibiotics. Because of this variability, bacteria must be grown and tested against a panel of antibiotics in order to find the best choice to treat infection. This is known as susceptibility testing. The healthcare team works closely assessing each patient and making the best decision for their circumstance. This timeframe is closely monitored by pharmacists, physicians, nurses and the laboratory to provide and execute the safest patient care possible.
The World Health Assembly in 2015 adopted a global action plan to address the issue of antimicrobial resistance. The goal of this action plan is to safeguard the use of antibiotics for prevention and treatment of infectious diseases. Antimicrobial stewardship is the multidisciplinary approach to the safe and responsible use of antibiotics, and hospitals around the world, including Marcus Daly, are adopting practices to improve antibiotic prescribing.
Healthcare is ever evolving and like our bacterial counterparts, we must adapt in order to thrive. As we look at the upcoming cold and flu season, please make a conscious effort to minimize infections and properly utilize antibiotics as a patient or a healthcare team member. Together as a community, we can all work to be good stewards of antibiotics and preserve this valuable resource to make our community a healthier place.
This week’s community health column is brought to you by Marcus Daly Memorial Hospital. For questions and or comments, please contact Cara Bushmaker, MLS(ASCP)CM, B.S. Micr. at the Marcus Daly Laboratory Department at 1200 Westwood Drive, Hamilton MT, 59840. Working together to build a healthier community!