Get Smart: Antibiotics overuse leads to resistance

Here's a scenario most parents are familiar with: Your child goes to sleep with a runny nose and wakes up with a fever and lots of pain in her ear. You head over to the pediatrician's office for a sick child visit, expecting to leave with a diagnosis of an ear infection and a prescription for antibiotics. Not so fast ...

Posted 2:00 a.m. Feb 11, 2015 — Updated 6:29 p.m. Apr 3, 2015

Sarah Lindenfeld Hall

Not so fast ...

For more than a decade, the Centers for Disease Control and Prevention and other agencies have warned against the overuse of antibiotics. Over the years, the drugs' effectiveness has been reduced because the diseases that the antibiotics have been designed to squash have changed just enough so that the drugs sometimes no longer work. That means the illnesses might no longer be treatable.

In thousands of cases each year, the results are devastating. According to the CDC, at least 2 million people are infected with an antibiotic-resistant bacteria each year. About 23,000 people die.

Doctors also are seeing high levels of infections caused by C. difficile, a bacteria that normally lives in the intestine. The illness often occurs in people taking antibiotics. It's typically been diagnosed in the elderly and others who are hospitalized. But doctors are seeing the infection more often in the community, outside the hospital setting. Each year, about 14,000 people die from the infection, according to the CDC.

"We’ve had to go back and pull out older, more toxic antibiotics that have been retired because they had so much toxicity, but we’ve had to pull them back into use to treat these infections," said Dr. Zack Moore, a pediatrician and medical epidemiologist in the N.C. Department of Health and Human Services' communicable disease branch. "But even with that, there are some infections that are literally untreatable. ... That’s a very scary situation."

But that message - that antibiotics should not be the first course of action when we're dealing with a runny nose, earache or fever - hasn't found its way into every doctor and patient conversation. The state launched a campaign late last year called Get Smart About Antibiotics to educate doctors and patients about antibiotics overuse.

"Antibiotics are obviously a life-saving intervention," Moore said. "It’s not an unlimited resource and the more antibiotics we use, the faster the bugs, or the bacteria, develop resistance. ... The bugs develop resistance really quickly."

Here's the deal: Antibiotics kill bacteria. They don't kill viruses, which cause illnesses like the common cold, flu, earaches and many sore throats. While some viruses can lead to a bacterial infection, taking an antibiotic when an illness is still caused by a virus is not going to do the patient any good, Moore said.

Antibiotics certainly have been a lifesaver for many families. Before the 1940s, when penicillin was first introduced, children died regularly from bacterial infections such as scarlet fever, strep, pneumonia and diphtheria.

"These things were fatal diagnoses," Moore said.

But, today, the pipeline for new antibiotics is drying up. Drug companies focus their efforts on finding treatments for chronic diseases, not medications that people need from time to time. While there are national efforts to fund the development of new bacteria killers, experts say we need to preserve the effectiveness of the ones we have now.

"Even if we had a steady stream of antibiotics coming to market, we would still have to worry about overuse and misuse," Moore said.

So, back to that visit at the doctor's office with a miserable kid with an ouchy ear. Studies have found that in 80 percent of cases, children will get better without an antibiotic, Moore said. What's more, antibiotics won't do anything to ease the child's pain.

Instead of leaving with a prescription for an antibiotic, they probably should be heading home with plans to use ibuprofen or acetaminophen to treat the pain and for a few days of rest.

"That's not something that parents want to hear if their children are hurting now," Moore acknowledges.

But it could help in the fight to ensure that antibiotics remain the potent bacteria killers that we've relied on for decades.

Go Ask Mom is partnering with the North Carolina Quality Center to help parents Get Smart About Antibiotics. For additional information and resources, see http://www.ncgetsmart.com.

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