I'm Dr. John Iskander.
Welcome to Beyond the Data.
I'm here today with Dr. Lauri Hicks, medical director
of CDC's Get Smart: Know When Antibiotics Work program.
So, Lauri, at this week's Grand Rounds,
we heard about the problem of excessive
and inappropriate antibiotic use.
What should people take home
about that issue in big picture terms?
Well, we know that in outpatient settings,
about 258 million courses of antibiotics are used each year.
And if you think about that, that's enough antibiotics
for four out of every five Americans.
That's just an incredible amount of antibiotic use just
in the outpatient setting.
And we believe that about 50 percent of all antibiotic use,
whether it's in hospitals or outpatient settings,
is unnecessary or inappropriate.
That's really quite remarkable.
Now, one thing we didn't have time to talk
about during the session, but which I know is of interest
to a lot of people is antibiotic use in animals,
on the farm, so to speak.
What should people know about the science behind that issue
and how concerned should they be?
Well, there's no question that animal use,
animal antibiotic use, has an impact on human health.
And I think about it
as antibiotic use anywhere is antibiotic use everywhere.
We have seen outbreaks of infectious diseases in humans
that have been acquired through our food supply,
and so we definitely need to work
to improve animal antibiotic use.
The question is, okay, where can we make improvements?
We know that antibiotics are still needed to treat infections
in animals but there is a lot of antibiotic use
for growth promotion for animals and so, we support FDA's efforts
to eliminate that practice.
Okay. So, coming back to, again, the more typical setting
where our audience might deal with antibiotics.
What should physicians and others
who prescribe antibiotics, what should their actions be,
right now, to better use antibiotics?
Well, we know that providers are under a lot of time pressures
in their offices and in the hospital
to prescribe appropriately, but we do want them
to take a step back and think about what are the guidelines
for appropriate prescribing.
There's lots of guidance out there to improve prescribing.
The first thing we want providers to ask themselves,
"Okay, does this patient have a bacterial infection?"
So, determine the likelihood of a bacterial infection.
Second question-they should be thinking about, okay,
what are the harms and the benefits
of prescribing this antibiotic
and weighing the risks and benefits.
We know that antibiotics are not harmless medications.
And then, finally, when an antibiotic is needed,
we want providers to prescribe the right drug at the right dose
and for the right duration.
So, those three steps, I want providers to be thinking
about those three steps every time they're thinking
about prescribing.
Okay. Very useful.
Now, on the other side of the prescribing pad, a patient's
and parents of children-what should they do
to educate themselves?
What are the actions that they can take, as patients,
to help us all better use antibiotics?
Yeah, it's without question that parents and patients play a role
in this problem and we need parents and patients
to help us improve antibiotic use.
And one thing I need parents and patients to think
about when they're going to their providers is
that antibiotics don't work to treat viruses.
They only work to treat bacterial infections.
So things like colds, flu, lots of-the coughs this time of year,
actually won't respond to antibiotic therapy.
We also want the parents and patients to go to the providers
and ask, you know, what's the best treatment
for my child's illness?
If a parent or patient demands an antibiotic,
they're much more likely to get one, even if it's not needed.
We used to say, at the state level,
sometimes the best medicine is no medicine.
Absolutely.
So, we often say, "wait and see."
If there is no indication that an antibiotic is needed,
"wait and see" may be the best approach.
So, are there any concluding points that our audience,
perhaps those working in the public health setting,
that they should be armed with to be able to, you know,
do their work better in promoting antibiotic use
or to educate their families in their communities?
What are some take homes for public health practitioners?
Well, I definitely feel like the public health practitioners play
a role in this, as well, and we must engage state
and local health departments when we're thinking
about improving antibiotic use in the community.
And so, we really need to work with our state
and local health department partners
to get the messages out there.
One thing we do every year is we have an observance,
Get Smart About Antibiotics week, and we partner
with our state and local health department partners.
We give them messages to disseminate to providers
and the general public.
So we will ask our partners to work with the messages
that we're providing and disseminate them
through various channels, whether professional societies
or their local partners, to get the messages
out to the general public and providers.
Okay. So, important actions that can be taken by those
who prescribe antibiotics, by those who take
or don't take antibiotics, and by those who work
in public health to promote better antibiotic use
to better conserve this precious resource for all of us.
Thank you very much, Dr. Hicks.
Thank you for joining us for CDC's Beyond the Data.
Please join us again next month.