Antibiotic Education by JessicaX2

J. Boschen and J. Kuhr

“An ounce of prevention is worth a pound of cure.”
~Benjamin Franklin

Background
Antibiotic misuse is a major cause of bacterial drug-resistance.4 Scientists and public health officials have been considering the varying benefits and detriments of many different methods of slowing the evolution of antibiotic or drug resistance. None of these methods has been shown to consistently reduce levels of antibiotic resistance.2 Few people know how antibiotics work, why antibiotic resistance occurs, and what the consequences of resistance can include. Today, the spread of antibiotic resistance is a major public health crisis of the 21st century.1 Public health care education on the proper use of antimicrobials is an important step in controlling the spread of this resistance. 3 Consumers need education and information so that they understand the value of antimicrobials and when treatments are appropriate. 3 The successful control of drug-resistant organisms includes education.5

Very few people without health degrees truly understand the implications of the misuse of antibiotics. Even within the health care profession, we find doctors that are taught about antibiotic resistance still following old-fashioned ideas over the use of antibiotics.3 Furthermore, new doctors are more likely to follow methods practiced by their superiors, such as prescribing antibiotics to patients that are not necessary, rather than the new protocol, which is only prescribing antibiotics to bacterial infections. Education clearly has been left on the back burner when it comes to fighting this pandemic of antibiotic resistance. “The warnings were there long ago, but too few people heeded them.” 4

Policy
Antibiotic use and resistance education programs are to be implemented in all Nebraska middle and high school.
In a cooperative manner, as the Nebraska State Health Officials and Public Board of Education we are instigating antibiotic use and resistance education be taught in public middle and high school education systems. Courses that will be expected to teach this material within their curriculums include Physical Education, Health, and Biology. This material will be incorporated as a week-long program. Materials will be updated on a five year rotation. At the conclusion of the program, students will be required to take a standard examination to evaluate their understanding of antibiotics and microbial resistance. It is recommended that along with these teachings, students be required to develop an informational brochure to be dispersed throughout the community in public venues. This will allow for the education to reach the entire community.

When a school system does not comply with this policy, a 2% deduction from the system’s athletic program funding will be observed. This penalty will be enforced so that the education of antibiotics and microbials will be taken seriously. 1% will be added during each consecutive year that the policy is ignored after the initial 2% deduction.

In order to provide teaching materials to every school district in the state of Nebraska, $100,000 will be budgeted into the public education forum. Funding will be accomplished by raising the sales tax by 0.01%. Individual taxpayers will only be paying about $0.05 more each year. This will also allow for the updating of materials every five years.

Conclusion
Providing the Nebraska Public Education System with the tools necessary to inform the consumers of tomorrow will be a successful step in controlling the spread of antibiotic resistance. Since misuse is one of the leading causes4, antibiotic resistance will experience a decline with proper education. We hope that other states will begin to implement systems of their own modeled after the policy in Nebraska. Some arguments that could be made against this policy include that reducing funding for athletics as punishment for not implementing the program will lower the school’s enrollment. Regardless, this area was chosen for punishment because removing educational funds is more damaging to the students. Second, one could argue that the program does not need to be established in each health, physical education, and biology course; one program would be sufficient. However, it is important to reinforce what has already been learned and to educate students with new advances and technology in the field. It is adamant that patients are better informed in order to send this crisis of growing antibiotic resistance into recession. The misuse of prescriptions is everyone’s responsibility. 6

References
1) Austin, D.J. and R.M. Anderson. “Studies of Antibiotic Resistance within the Patient, Hospitals, and the Community”. The Epidemiology of Infectious Diseases 354(1384). April 1999. pp. 721.
2) Boni, M.F. and M.W. Feldman. “Evolution of Antibiotic Resistance by Human and Bacterial Niche Construction”. Evolution: The International Journal of Organic Evolution. 59(3). March 2005. pp. 477.
3) Leidl, P. “Overcoming Antimicrobial Resistance”. World Health Organization Report on Infectious Diseases. 2000. ch. 3 and 5.

4) Levy, S.B. “Antibiotic Resistance: Consequence of Inaction”. Clinical Infectious Diseases 33(Supp. 3). Sept. 2001. pp. 124.
5) Siegel, J.D., E. Rhinehart, M. Jackson, L. Chiarello. “Multidrug-Resistant Organisms in Healthcare Settings”. Report from Healthcare Infection Control Practices Advisory Committee. 2006. pp. 12
6) Standing Medical Advisory Committee. “The Path of Least Resistance”. Report from the UK Department of Health. 1997. pp. 26.

© Copyright 2009 J. Boschen and J. Kuhr

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