As the medical community develops treatments to fight the coronavirus, another deadly enemy remains lurking in hospitals across the country: antibiotic-resistant infections.
The Centers for Disease Control and Prevention consider antibiotic resistance to be one of the “biggest public health challenges of our time,” and a new study suggests that doctors may be partially to blame for its prevalence.
The study, published last week in the scientific journal JAMA Network Open, found that more than half of antibiotics prescribed in hospitals were not consistent with the recommendations, alarming health experts who say that inappropriate prescription of drugs contributes to antibiotic resistance.
“We are in an antibiotic crisis. Many call this a ‘silent pandemic’ that occurs simultaneously with the coronavirus pandemic,” said Dr. Debra Goff, an infectious clinical pharmacist and professor of pharmacy who leads antibiotic resistance efforts at the University Ohio State at Wexner Medical Center.
In the agency’s study, the researchers analyzed 1,566 patients who received antibiotics and found that 55.9% should not have received them based on practice guidelines.
The guidelines did not support the prescription of antibiotics for 79.5% of patients who were treated for community-acquired pneumonia and 76.8% of patients who were treated for a urinary tract infection.
Prescriptions were flagged if there were no documented signs or symptoms of infection, no laboratory results, or if antibiotics were prescribed for longer than necessary.
Of the patients who may have received unnecessarily prescribed antibiotics, more than 50% had no documented signs or symptoms of infection and almost 60% received medications for an excessive duration.
Patients usually receive antibiotics when they are hospitalized and then prescribe a new course of antibiotics when they are discharged, says Goff, prompting them to take medication for up to two weeks.
“These antibiotic-based football scores – 7, 10, 14 days – were not developed based on studies of clinical outcomes. These durations were just how the researchers designed the study, ”she said. “(But) there is data that clearly shows that these traditional durations are no longer needed … the shorter the better.”
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Taking antibiotics longer than necessary increases the patient’s chance of developing antibiotic resistance, said Dr. Ryan Shields, an infectious disease pharmacist and associate director of the antibiotic management program at the University of Pittsburgh Medical Center.
This occurs when germs such as bacteria and fungi develop the ability to defeat drugs designed to kill them, according to the CDC.
Studies have shown that patients with antibiotic-resistant infections are at higher risk for worse clinical outcomes, such as severe illness and death, compared to patients with infections that can be treated with antibiotics.
This may be due to significantly longer hospital stays, a high risk of treatment failure and an increased risk of undergoing surgery, said Goff. According to the CDC, more than 35,000 people die from antibiotic-resistant infections in the United States each year.
They are not only deadly, but expensive. According to a January report by the CDC and the University of Utah, six multidrug-resistant pathogens are estimated to cost the United States more than $ 4.6 billion annually.
“Every day they are in the hospital consuming resources,” said Goff. “Add it all up … antibiotic resistance costs a lot of money.”
In addition, antibiotics that specifically treat antibiotic-resistant pathogens are more expensive than traditional antibiotics, costing about $ 400 to $ 1,000 a day, compared to about $ 25.
The CDC study was carried out between 2011 and 2015, which means that prescribing practices have probably changed since the report, said UMPC’s Shields. In 2017, the Joint Commission put in place a new accreditation standard for hospital antimicrobial administration programs to educate staff and doctors about antibiotic resistance.
However, it is not just doctors who have a responsibility to fight antibiotic-resistant infections, health experts say. Often, the main reason why patients visit the doctor is to obtain a prescription for antibiotics.
“When you pay for a doctor’s appointment, many go to the doctor to take the antibiotic. They put pressure on the doctor, ”said Goff. “This is where the consumer and patients also need education.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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This article was originally published in USA TODAY: ‘Superbugs’ kill more than 35,000 Americans each year. Are doctors guilty?