Judicious antibiotic prescribing easier said than done

By Matt Kuhrt

Antibiotics are both the doctor's best friend and worst enemy. Used properly, they save lives; but their overprescription hastens the rise of resistant strains of bacteria. The sweet spot for judicious use of antibiotics is harder to find than you might think, and that's not good news in the fight against resistant superbugs, according to an article in MedicalXpress.

The real eye-opener is that the standard duration of an average antibiotic course prescribed by a general practitioner has more to do with the number of pills in the packet than hard science, according to the article. Recommended durations for new drugs get derived from the studies that came before them, and in many cases, shorter treatment regimens have not been tested.

On top of this, no matter how attuned physicians may be to the dangers of prescribing antibiotics unnecessarily, and regardless of how much they try to educate patients about the problem, the deck is stacked against them when a patient presents with a symptom that may or may not respond to antibiotic treatment, the article suggested.

A new diagnostic tool in development could help to clarify whether infections are caused by a virus or by bacteria by analyzing the gene activity in blood samples, Stat reports. Unfortunately, the current technology takes 12 hours to make a diagnosis, which isn't quick enough for a doctor or patient worried about a potential problem. In these situations, it's all too easy to think of general public welfare as secondary to a patient for whom the treatment will, at worst, at least do no immediate harm.

Unless and until this type of technology can be refined and applied at the point of care, the chances of turning the overprescription tide rely on changing attitudes and generating better data to optimize course duration.

So far, that's proving to be a tough slog, according to Stat. The unnecessary antibiotics represent "huge downsides that are killing people on a regular basis," said Timothy Lahey, M.D., an infectious disease specialist at Dartmouth's Geisel School of Medicine, "but they're less immediate than the person in front of you."

To learn more:
- read the article in MedicalXpress
- learn about the new diagnostic testing possibilities in Stat