jack's policy paper

Antibiotic Dose Alert System
By Jack Bush

Antibiotic resistance can be a big problem for medical clinics. As the president of the board of directors for a small medical clinic, I plan on enforcing a new policy that will hopefully(where is your confidence???) lead to the reduction of antibiotic resistance and also improve our doctor to patient relations. If we are to effectively combat antibiotic resistance, this clinic’s patients must be compliant with their frequency of dosages and completely finish their regimens of antibiotics.
Often times, the clinic’s patients forget to take their antibiotics at their scheduled times and miss their dosages of antibiotics. For example, a survey revealed that among patients treated for Chlamydia trachomatis, 90% said that they were taking doxycycline according to the instructions. Objective electronic testing indicated that in fact only 16% were fully compliant (4). Another study has shown that patients with treatment periods longer than 7 days are more likely to be less compliant with the frequency of their dosages (5). Some also find it hard to be compliant when they have to take several doses during the day when they are busy at work (3).
Some bacteria are able to survive at low concentrations of antibiotics (2). When antibiotic dosages are taken at correct frequencies, a high enough concentration is maintained to keep the bacterial growth levels down. When antibiotics aren’t finished or dosages of them are missed, the weakest and most susceptible bacteria are killed and the more resistant bacteria survive and flourish (1).
Many adolescents have had recurrences of ear infections due to incomplete regimens of antibiotics and missed doses. Often times, infected people end up getting the same infection back when they are careless about when they take their antibiotics.
The reoccurrences(spelling) of infections happen when someone stops taking their antibiotics as soon as they start feeling better. At this point, the antibiotics have only killed enough of the bacteria to make the patient start to feel better. The bacteria that haven’t been killed will begin to exponentially multiply at ease with the absence of antibiotics and will regenerate their numbers. When the slightly more antibiotic-resistant bacteria have sufficient numbers, symptoms will return. In order to kill off this bacterial infection, a stronger dose of the previously prescribed antibiotic will be required. Sometimes a different antibiotic all together is needed.
The way I propose this center does its part to combats antibiotic resistance is to enforce a new policy which helps its patients remember to take their antibiotics on time. It is called the antibiotic dose alert system.

1.) All patients must give consent to participate in the antibiotic dose alert system.
2.) A text will be sent from the doctor to the patient’s cell phone when it is time to take their next dose of antibiotics.
An example of an appropriate text:
“Hi Mary, it’s Dr. Bush reminding you that it’s time for another dose of penicillin.”
3.) Patients without a texting plans will receive a phone call.
5.) Doctors at the clinic will receive company phones with unlimited minutes and texting to allow for this policy.
6.) Compliance with the antibiotic dose alert system will result in the ability of doctors to use work phones outside of work hours for personal calls and texts.

This policy will be most beneficial to people with longer treatment periods and anyone who lives a busy lifestyle. It will hopefully reduce the number of returning patients with similar symptoms. It will cost the insurance companies less money by having fewer doctors’ visits and prescribing fewer antibiotics. I hope that his(???, spelling or this) new policy might also better our doctor to patient relationships all for the sake of reducing antibiotic resistance.

1.) LM Wahl, MA Nowak - Proc. R. Soc. Lond. B, 2000. “Adherence and drug resistance: predictions for therapy outcome” <pubmedcentral.nih.gov>
2.) IM Gould, FM MacKenzie - Journal of applied microbiology, 2002. “Antibiotic exposure as a risk factor for emergence of resistance: the influence of concentration” <interscience.wiley.com>
3.) Journal of Antimicrobial Chemotherapy (2002) 49, 897-903
© 2002. “Patient compliance with antibiotic treatmentfor respiratory tract infections” The British Society for Antimicrobial Chemotherapy
4.) Bachmann, L. H., Stephans, J., Richey, C. M. & Hook, E. W, III (1999). Measured versus self-reported compliance with doxycycline therapy for chlamydia-associated syndromes: high therapeutic success rates despite poor compliance. Sexually Transmitted Diseases 26, 272–8.[Web of Science][Medlin
5.) Reyes, H., Guiscafre, H., Munoz, O., Perez-Cuevas, R., Martinez, H. & Gutierrez, G. (1997). Antibiotic noncompliance and waste in upper respiratory infections and acute diarrhea. Journal of Clinical Epidemiology 50, 1297–304.[Web of Science][Medline]

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