06-01-09 RODALE NEWS, EMMAUS, PA—Antibiotic-resistant diseases are one of the most pressing public health problems in this country, according to the U.S. Centers for Disease Control and Prevention (CDC). Some scientists suspect that our love affair with antimicrobial products, such as antibiotic-laced bedsheets and hairbrushes, are contributing to the rise of bacteria that can shrug off medicine used against them. But the CDC still points the finger at the widespread use of antibiotic medications, often prescribed even when they’re not effective at treating a patient’s illness. A new study published in the British Medical Journal suggests another way, finding that doctors trained in certain types of blood tests and communication skills were very successful in treating certain conditions without relying on antibiotics.
THE DETAILS: Researchers in Norway recruited 40 physicians with patients suffering from lower-respiratory infections. They focused on these types of infections since they are often treated with antibiotics, despite the fact that the infections could be viral in nature and therefore not susceptible to those particular drugs. The doctors were divided into four categories: one group that did blood tests on patients, another that communicated the risks and benefits of antibiotics, another that combined both methods, and a fourth that continued with usual diagnostic and treatment procedures. Physicians in the blood test and the communication groups prescribed 22 percent and 27 percent fewer antibiotics, respectively, than the group following usual procedures. Doctors who were trained in particular communication points (asking patients their opinions and concerns about antibiotic use and providing information on the natural course and symptoms of a lower respiratory tract infection) also prescribed fewer antibiotics than the doctors performing blood tests. The doctors who used both blood tests and effective communication prescribed the least antibiotics, 44 percent fewer than the “usual procedures” group.
WHAT IT MEANS: While antibiotics often aren’t the cure for what ails you, tools currently available to doctors aren’t always up to the task of distinguishing between infections that are or aren’t curable with antibiotics, says Stuart Levy, MD, professor of microbiology and medicine at Tufts University Medical School and president of the Alliance for the Prudent Use of Antibiotics. “Even under the best circumstances, antibiotics will be prescribed for viral illnesses because we don’t have the diagnostics to know difference,” he says. Studies like this one will help doctors and their patients find ways to manage illnesses without using antibiotics unnecessarily.
As we all get wiser about antibiotic use, here are some points to keep in mind when you’re feeling under the weather:
• Ask for a blood test. The blood tests used in this study looked for C-reactive proteins, proteins in the blood that may signal a bacterial infection. They’re an effective tool for distinguishing between bacterial infections and viruses. Ask you doctor if this might be a helpful strategy in your case.
• Don’t take anything, and call him in the morning. Let your physician know that you don’t want antibiotics if they’re not needed. He or she may be thinking the same thing but hesitant to suggest it you don’t speak up. “Doctors try to avoid filling prescriptions,” says Dr. Levy. If you feel leery of taking one, say so, and “in many cases, the doctor will hand you a prescription and tell you not to fill it unless you’re still not feeling better the next day.”