Parents, patients targeted for antibiotic education

GERM Commission launches education effort

Public education efforts in San Diego to draw attention to the problem of antibiotic resistance include a message to parents from pediatricians and a general patient information handout. Highlights of the educational materials are summarized as follows:

Notice to parents: The United States recently has experienced a dramatic rise in the numbers of bacteria that have developed resistance to our standard antibiotics. As pediatricians, we can no longer be confident in the treatment of such common infections as ear infections (otitis media) with safe, easily available, and inexpensive antibiotics such as amoxicillin. Although newer antibiotics are becoming available to treat many of the infants and children with these infections, we all have concerns that with increasing use of the newer antibiotics, we will see the bacteria develop resistance to these antibiotics as well.

As a parent, you may have come to expect that every time your child had a fever and was seen by a doctor, you would be given antibiotics for your child "just in case" a bacterial infection may be present somewhere. Unfortunately, we now realize that this kind of antibiotic use has now created a problem with antibiotic-resistant bacteria, which, when they actually do cause infections, no longer respond to our usual antibiotic treatment. We ask for your patience as medical practice in the U.S. changes, and antibiotics are not prescribed as frequently. Your doctor may not give you an antibiotic for your child, even if your child has a fever, unless your doctor really thinks that antibiotics will cure a bacterial infection. Your doctor may ask to call you at home or have you return for a visit to check on your child rather than to simply prescribe an antibiotic. We believe that this change in how doctors treat our young patients is good medical practice and that by not prescribing antibiotics "just in case," we can prevent the development of bacteria that are resistant to all antibiotics.

Information for adult patients: Overuse of antibiotics is one of the reasons why the "standard" antibiotics no longer cure common bacterial infections. The following information is provided for you so you will better understand why antibiotics may not be prescribed when there is an "infection." Consult your physician if you have persistent high fevers and if your symptoms get worse.

• Antibiotics are not useful for the treatment of viral infections such as the common cold. Symptoms of viral upper respiratory infection include: sore throat associated with nasal congestion, runny nose, dry cough, and low-grade fevers.

• Viral upper respiratory infections may be associated with acute bronchitis characterized by discolored phlegm and a persistent hacking cough. Such symptoms may persist for weeks, do not require antibiotics, and will resolve.

• When there is a history of chronic bronchitis (daily morning cough with phlegm, cigarette cough), antibiotics are helpful when acute bronchitis (increasing cough, change in color of the phlegm) develops.

• "Shopping around" for the "right" antibiotic if one "doesn’t work" has no rationale for cold symptoms since the infection will likely go away on its own.

• Not all earaches or sinus congestion/ drainage indicate an infection. Sometimes this can be caused by fluid and can be treated by decongestants. Your doctor is able to tell the difference.

• For travelers to foreign countries who are given antibiotics to take along just in case you get diarrhea: Most traveler-type diarrhea goes away on its own and does not require antibiotics. Antibiotics are to be used only when the diarrhea is bloody and there are high fevers.

• Do not take antibiotics left over just because you have a fever. This may make it more difficult for your doctor to find out why you are sick.

• Antibiotics given to one person should never be taken by another person.

• Because purchasing antibiotics in Mexico does not require a prescription, it is easy to obtain antibiotics there, but you should not take any antibiotic unless instructed by your doctor.

• When an antibiotic is prescribed, it should be taken until all the drug is gone.