U.S. Hospitals Overuse, Misuse Antibiotics, CDC Says
TUESDAY, March 4, 2014 -- Many hospitals across the United States overuse or misuse antibiotics, which fuels the growth of drug-resistant bacteria, federal health officials warned Tuesday.
Doctors in some hospitals prescribe three times more antibiotics than doctors in the same departments at other medical centers, according to a new report from the U.S. Centers for Disease Control and Prevention.
"We have to protect patients by protecting antibiotics," CDC Director Dr. Tom Frieden said during a noon press briefing Tuesday. "The drugs we have today are in danger, and any new drugs we get could be lost just as quickly if we don't improve the way we prescribe and use them."
The agency outlined ways hospitals can improve their prescribing practices through recommended "antibiotic stewardship" programs.
The CDC also is seeking a $30 million increase in the fiscal 2015 budget to help identify antibiotic-resistant germs, Frieden said.
"Antibiotics are nothing short of miracle drugs, and it's important that antibiotics are used promptly whenever needed," he said. The way to preserve them is to not use them when they're not essential, experts say.
Unnecessary antibiotic use exposes patients to potential complications without any medical benefit. One such complication is Clostridium difficile infection, according to the CDC Vital Signs report.
A 30 percent reduction in use of antibiotics that open the door for C. difficile could reduce these serious infections by more than one-quarter, according to the report. Diarrhea caused by C. difficile is linked to 14,000 deaths in the United States each year, according to the CDC.
Overuse of these same antibiotics also increases the likelihood that patients will come down with super-resistant infections in the future, officials said.
CDC researchers reviewed antibiotic prescriptions at more than 300 hospitals in 2010 and found more than half of hospital patients got an antibiotic during their stay. Most prescriptions for antibiotics are written for urinary tract infections, lung infections and infections caused by drug-resistant Staphylococcus bacteria, such as MRSA.
One-third of the prescriptions for vancomycin -- often considered an antibiotic of last resort -- and one-third of antibiotics prescribed to treat urinary tract infections were ordered without proper testing or evaluation. Or they were prescribed for too long, the report found.
Having a formal approach to this problem is a way of holding doctors accountable, said Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City.
"This is an important step," he said. "Over-prescription is a huge problem when it comes to antibiotic resistance."
To curb misuse and abuse of antibiotics in hospitals, the CDC recommends:
- Appointing a doctor to lead a program on responsible antibiotic use.
- Appointing a pharmacist to improve antibiotic prescribing.
- Starting with at least one step, such as requiring prescriptions be reassessed within 48 hours.
- Monitoring patterns of prescribing and antibiotic resistance.
- Reporting data on prescribing and antibiotic resistance to doctors.
- Educating doctors about the danger of antibiotic resistance.
Frieden said he believes antibiotic resistance can be overcome if the CDC-recommended steps are instituted throughout the country.
"It's not too late. We can reverse drug resistance," Frieden said. With funding, it would be possible to reduce the rate of C. difficile by half in five years, "preventing thousands of deaths, hospitalizations and health care costs," he said.
"If we lose our antibiotics, not only will we lose our treatment of primary infections, but the treatment of other infections that complicate many other conditions," Frieden said.
For more information on antibiotic overuse, visit the U.S. Centers for Disease Control and Prevention.
Posted: March 2014
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