resistance paper

Willie Pfau
Ryan Klein
Microbiology Policy Paper
October 2, 2009
The Prevention of Antibiotic Resistance
Background:
Everyone seems to come down with a cold sometime in their adolescent lives. So what does the usual parent do? They try to help their child cope, or if it is severe enough they take their child to the doctor’s office and one bring home some sort of antibiotic. This is not a good thing! Bacteria are not the cause of the common cold, it is a virus. The common cold is the most prevalent disease in humans and is generally caused by a rhinovirus. In most cases, antimicrobial agents are not needed. Indeed, there is no role for antibiotics in managing uncomplicated colds.2With antibiotic resistance being one of the top public health problems, one can see why it is a bad idea to give antibiotics to someone that does not have a bacterial infection to try and cure them.
Even though there is limited to no effectiveness and sometimes harm, with the misuse of antibiotics, some general practitioners still tends to prescribe them for use against the common cold. This misuse of antibiotics brings extra costs to the patients and is part of the reason why bacteria are becoming resistant. So with more strict restrictions this can be slowed down or even prevented.
Policy:
Antibiotics should not be prescribed to patients with the cold, particularly adolescent children. There should be a law made regarding this situation. When patients go to the pharmacist for a prescription for antibiotics, the prescription has to explain precisely their condition and what is being used to treat it. Instead of the prescription just saying ‘amoxicillin’ and ‘dose of 500 milligrams,’ the reading on the prescription should show a description of what type of illness the person has, the name of the bacteria, the recommended antibiotic as well as the proper dosage.
When the doctor is diagnosing the patient to have a bacterial infection they are to perform tests to make sure they are in fact infected with a bacterial microbe. To do this they would need to make a culture of the suspected bacteria to make sure it is a bacterial infection. Only after this can they prescribe an antibiotic to help cure the patient. Failure to comply with this policy will result in a suspension of the license for the doctor. For the first offense, the suspension will be up to three months depending on the circumstances. The second offense, depending circumstances, will be up to 6 months. The third offense could be suspension of the license for up to one year or a loss of the license, depending on the severity of all three offenses.

The added costs would come with extra work from the doctors to ensure that the infection is indeed bacterially caused. So there would be an extra lab fee to culture out the bacteria. This could be a minimal cost or a rather expensive thing depending how difficult the bacteria is to culture. Also there could be added time for the patient to get their medicine because they would need to wait for the test results to come in.

One argument that could be made against the extra precautions of making sure a patient is actually infected with a bacterial microbe, would be the added time needed to get the results from the lab. Also, pharmacies would take longer to fill prescriptions, ensuring that everything is written and processed correctly. People would not see the need for the extra precautions taken and could aggravated not getting their prescription right away. This can easily be countered by telling the patient why the tests are being done and in fact making sure prescribing them with antibiotics will indeed help them get better instead of alternative medicines.

Another argument could be made about the expense of this policy. It would be expensive to culture out the bacteria in the lab. The time the lab technician takes for that will also be in effect, as he or she won’t do it for free. So the charges at hospitals and clinics will go up for patients. This cost increase could partially be taken care of by the insurance of patients. The rest of the cost will just have to be covered by the patients.

Conclusion:

Doctors’ roles in the prevention of antibiotic resistance needs to become larger, for the fact that they have so much control over what patients receive for medication. This policy will decrease antibiotic resistance by not prescribing unneeded antibiotics, especially the common cold. This would be unnecessary exposure to the bacteria, thus making them more likely to become resistant to antibiotics in the future. The use of unnecessary antibiotics will be stopped, upon the enforcement of this policy.

Works Cited

1
B. Arroll, Kenealy, Kerse. “Do Delayed Prescriptions Reduce the Use of Antibiotics for the Common
Cold?” The Journal of Family Practice. 51.4 (2002). www.jfponline.com.
2
Curry, Misty, Linda Sung, Bruce Arroll, Felicity Goodyear-Smith, Ngaire Kerse, and Pauline Norris. “Public
Views and use of antibiotics for the common cold before and after an education campaign in
Zealand.” The New Zealand Medical Journal 119.1233 (2006). www.nzma.org. 06 May 2006.
Web. 26 Sept. 2009.
3
Mark Ashworth, Kate Cox, Radoslav Latinovic, Judith Charlton, Martin Gulliford, Gill Rowlands. “Why
Has Antibiotic Prescribing for Respiratory Illness Declined in Primary Care?” Journal of Public
Health. 26.3 (2004). www.jpubhealth.oxfordjournals.org.
4
I.M. Gould. “A Review of the Role of Antibiotic Policies in the Control of Antibiotic Resistance.” The
Journal of Antimicrobial Chemotherapy. 43.4 (1999) www.jac.oxfordjournals.org.
5
“Get Smart: Know When Antibiotics Work” Centers of Disease Control and Prevention. (2008).
www.cdc.org.

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