House Calls

SUM 2019

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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J ust over a century ago, infection was one of the most common causes of death in America. Pneumonia, influenza, tuberculosis, and gastrointestinal infections killed more people than cancer, heart disease, and many other illnesses combined. Today, not only is pneumonia not a death sentence, it can often be treated easily at home after a quick visit to the doctor and a course of antibiotics. 32 { summer 2019 } h o u s e c a l l s Nationwide, about 10 percent of people in the U.S. are noted to have a penicillin allergy. However, studies have shown that up to 90 percent of these people don't—or don't anymore—notes Roper St. Francis Healthcare aliated pharmacist Radha Patel. "There are several reasons someone may no longer have a true penicillin allergy," says Patel, who leads the penicillin clarification eorts at Roper St. Francis. "Many people are labeled allergic after experiencing common unpleasant side eects such as nausea, vomiting, or diarrhea," she says. (True symptoms of a penicillin allergy include itchy hives, swelling, and shortness of breath.) "Others may have outgrown their allergy," she adds. In one study, 80 percent of people tested had lost sensitivity to penicillin 10 years after being diagnosed. The problem? People with a penicillin allergy—or those who believe and say they have one—are often prescribed broad-spectrum antibiotics, which are linked to increased antibiotic resistance. Using allergy tests, Patel and others work to identify which patients have a true penicillin allergy—and thus must receive these alternative antibiotics—and which may safely use the preferred narrow-spectrum dose of penicillin. If you think you have a penicillin allergy, ask your primary care doctor if you're a candidate for an allergy test to be sure. ARE YOU ALLERGIC TO PENICILLIN? Indeed, antibiotics are considered one of the most revolutionary medical developments of the 20th century and have saved many millions of lives. Yet there's a second chapter to this story that's not so rosy: As antibiotic use soared throughout the second half of the 20th and into the 21st centuries, rates of antibiotic resistance— or the evolution of bacteria and fungi not treatable by available antibiotics—rose, too. The World Health Organization calls antibiotic resistance "one of the biggest threats to global health, food security, and development today," and the Centers for Disease Control and Prevention (CDC) notes that, without a shift in the current trajectory of antibiotic resistance, common infections like pneumonia could once again become deadly threats. "Antibiotics save lives, but when they are misused, they can cause trouble," says Sara Utley, lead pharmacist of the antimicrobial stewardship program at Roper St. Francis Healthcare. Across the country, experts like Utley are implementing a new suite of strategies to help ensure that antibiotics remain a powerful tool in the fight against infection. UNDERSTANDING ANTIBIOTICS An antibiotic is a medicine that either kills or impairs bacteria by sticking to and interfering with the organism's ability to grow and survive. Some antibiotics, like penicillin, are highly targeted and only bind to and interfere with specific types of bacteria. These are called narrow-spectrum antibiotics. Others, such as Augmentin and Levaquin, are more general in their approach, affecting a wider variety of bacteria. For these broad- spectrum antibiotics especially, it's important to note that they don't just target "bad" bacteria—they can also kill the "good" bugs found in our digestive system. This can cause side effects such as nausea, vomiting, and diarrhea, as well as long-term damage to the gut microbiome, which recent research shows is a key player in weight management, immune health, and much more. "For generations, antibiotics have been promoted because of their beneficial effects," says Roper St. Francis Healthcare affiliated infectious disease doctor Kent Stock, who is chair of the antimicrobial stewardship program. "However," he continues, "it is important to spend equal time talking about their side effects and the risk of antibiotic resistance." HOW RESISTANCE OCCURS When bacteria are exposed repeatedly to antibiotics, they can mutate and adapt to resist the medications—a situation known as antibiotic, or antimicrobial, resistance. Antibiotic resistance is a natural process, and one that scientists predicted as being a danger to the effectiveness of antibiotics as early as the 1950s, when the medicines first hit the mainstream market. But the prompt effectiveness of infection-blasting antibiotics overshadowed P H O T O G R A P H S B Y U T L E Y M A R Y K A T H O E S E R & B O T T L E A D R A G A N / S H U T T E R S T O C K Sara Utley

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