Most people know that antibiotics are used to fight infections. Millions of lives have been saved by their ability to combat bacterial infections.  Many people are unaware, however, that antibiotics are not effective for all types of infections, specifically those due to viruses.  Inappropriate use of antibiotics has led to the new problem of antibiotic resistance. One of the best known examples of antibiotic resistance involves bacteria known as MRSA, which stands for methicillin-resistant Staph aureus. Let's look at when it is appropriate to use antibiotics and learn about the "ugly side" of indiscriminate antibiotic use-----antibiotic resistance.

Antibiotic resistance is the ability of bacteria to resist the effects of drugs.  It is considered to be one of the world's most pressing public health problems. The number of bacteria resistant to antibiotics has increased in the last decade, in large part because of inappropriate antibiotic usage. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. Drug-resistant bacteria do not respond to more common and less expensive antibiotics, and in some cases may not respond to any antibiotic currently available. This can lead to serious infections that require more powerful (and expensive) antibiotics, hospitalizations, and sometimes surgical procedures. There are also many instances in which resistant bacterial infections have caused deaths. There is the potential for antibiotic resistance to develop anytime an antibiotic is used, so it is important that they be given only when absolutely necessary.

In September, 2003, the Centers for Disease Control (CDC) launched their 'Get Smart' campaign to reduce the incidence of antimicrobial-resistant disease by "knowing when antibiotics work."  Along with the CDC, health care providers and patients also play an important role in improving the appropriateness of antibiotic use.

Recommendations for health care providers:

• Only prescribe antibiotic therapy when likely to be beneficial to the patient
• Use an agent that targets the specific organism responsible for the infection
• Prescribe the antibiotic for the appropriate dose and duration

In a nutshell, this means that doctors should only prescribe antibiotics when a bacterial (rather than viral) infection is suspected, and should chose the antibiotic that is most likely to be effective for the specific bacteria responsible for that infection.  Colds, flu and most cases of sore throat or runny nose do not need antibiotics. They are caused by viruses and in most instances the body is able to combat the infection on its own.

Advice for patients:  The CDC has offered the following recommendations to encourage appropriate antibiotic usage and prevent the development of resistant bacteria.

• Tell your healthcare professional you are concerned about antibiotic resistance.
• Ask your healthcare professional if there are steps you can take to feel better and get symptomatic relief without using antibiotics.
• Take the prescribed antibiotic exactly as your healthcare professional tells you.
• Discard any leftover medication.
• Ask your healthcare professional about vaccines recommended for you and your family to prevent infections that may require an antibiotic.
• Never skip doses or stop taking an antibiotic early unless your healthcare professional tells you to do so.
• Never take an antibiotic for a viral infection like a cold or the flu.
• Never pressure your healthcare professional to prescribe an antibiotic.
• Never save antibiotics for the next time you get sick.
• Never take antibiotics prescribed for someone else.

For more information on appropriate antibiotic use see the "Get Smart" pages on the CDC's website.

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