Antibiotics overused in hospitals

Use of antibiotics at a group of US academic medical centres rose 7% from 2002 to 2006, Ronald Polk of Virginia Commonwealth University and colleagues reported in the journal Archives of Internal Medicine.

"We know from past experience that when we start using any antimicrobial drug excessively, that resistance to that drug eventually appears," Polk said in a telephone interview.

Use available drugs better
"Given the fact that there are very few new antimicrobial drugs being discovered, the message is that we really need to learn how to use the available drugs better."

The researchers tracked data on anti-bacterial drugs at 22 hospitals around the United States over the full five years.

In 2006, based on information from 35 such university teaching hospitals, the researchers found that 64% of patients were given at least one dose of an antibiotic.

As doctors prescribe more antibiotics, experts are alarmed that drugs that once killed the germs no longer do so, meaning an illness may last longer and be more likely to be fatal.

Drug-resistance issue
Health care costs also rise when infections defy standard antibiotics. Resistance to drugs can render them useless.

Use of Wyeth's Zosyn, also called piperacillin-tazobactam, rose 84% from 2002 to 2006 at the hospitals studied, while use of vancomycin rose 43%, the researchers said. Both drugs are given to treat numerous bacterial infections.

Aside from those two, other antibiotic use was stable.

While over-use of antibiotics is a major concern of public health experts, documentation of the problem at US hospitals has been difficult to come by. Polk said the findings at these hospitals probably reflect trends across the United States.

Only use when truly necessary
Polk said hospitals need to use antibiotics more judiciously, giving them to patients only when truly necessary. He added that hospitals should operate "stewardship programs" to ensure wise use of the drugs.

Antibiotics generally are safe for patients and cheap.

"It's easy to get into a mind-set of just using them for any trivial condition," Polk said. "We are undoubtedly over-using these drugs. But having a positive impact on that trend of over-use is a tough thing to do."

Patients must understand that when it comes to antibiotics, less is often better, Polk said. He called it a cyclical problem - more bacterial resistance to one drug leads to use of other drugs, thus causing more resistance to those drugs. – (Will Dunham/Reuters Health)

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November 2008