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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h o u s e c a l l s { summer 2019 } 33 "Antibiotics save lives, but when they are misused they can cause trouble." — PHARMACIST SARA UTLEY Sara Utley Medical professionals aren't the only group that should be concerned with antibiotic resistance. Here are a few steps you can take to protect yourself and your family from the risk of infection and to help fight antimicrobial resistance. 5 Reduce your risk. "The best way to avoid antibiotic use is to avoid preventable infections in the first place," says Dr. Stock. That means following commonsense tips like washing your hands to prevent the spread of germs, keeping cuts or scrapes clean, and seeking prompt medical care if you think you have an infection. It also means staying up to date on vaccinations for conditions that might otherwise need antibiotics to treat, such as whooping cough and diphtheria. 5 Recognize the limits of antibiotics. "Antibiotics are only helpful against bacterial or fungal infections," says Dr. Stock. They should not be used to treat conditions caused by a virus, such as the common cold, bronchitis, the flu, and most sore throats. 5 Follow your doctor's orders. "It's imperative to take the prescribed dose for antibiotics," stresses Utley. If you end up with leftovers, the best way to dispose of them is by finding a medicine take-back option like Roper St. Francis's periodic Drug Take Back days. "Unused prescriptions that are flushed or tossed in a landfill can end up in our waterways, which contributes to the problem," she says. Another necessity is the tightening of at-home use of antibiotics, which the stewardship team at Roper St. Francis is focused on now. "Antibiotics are still very helpful—and very necessary—tools for fighting infection," says Dr. Stock. "But we have to ensure they are only being prescribed when absolutely necessary and that they are being taken as directed." Resistance rates will never return to zero—infectious organisms simply evolve too quickly in the modern environment. However, carefully considered use of antibiotics can vastly slow down that process and minimize the spread of resistant bacteria. "It takes teamwork," says Utley. "But we've already seen what's possible when we come together to help tackle this issue." DO YOUR PART! those warnings and, in the following decades, the medications were used to treat all sorts of ailments, including infections that weren't bacterial, like viral cases of the common cold and flu. Meanwhile, farmers began administering antibiotics to livestock to raise heavier, healthier animals amid factory conditions. In fact, according to 2018 data from the Food and Drug Administration, 80 percent of antibiotics used in the U.S. are given to livestock. In recent decades, the rate of antibiotic resistance has skyrocketed. In 2013, the CDC released a report on 18 of the most serious antibiotic-resistant threats in the U.S. The list—the most recent of its kind—mentioned strains of bacteria and fungi that are becoming difficult to treat by antibiotics and included recognizable names like pneumonia, tuberculosis, and salmonella. The most urgent threats, however, are three bacterial strains (C. difficile, drug-resistant Enterobacteriaceae, and N. gonorrhoeae) that have become immune to almost all available antibiotics. Together, these infect hundreds of thousands of Americans annually and lead to extended hospital stays, aggressive treatment methods, and the risk of death. FIGHTING THE RESISTANCE In response to this epidemic, public health officials, policy makers, doctors, pharmacists, and individuals throughout the world are teaming up to combat antimicrobial resistance and reduce the spread of antibiotic-resistant bacteria—efforts collectively known as antibiotic stewardship. As hospitals are home to some of the most vulnerable citizens, antibacterial stewardship within their walls is an important part of the battle. Utley and Dr. Stock are members of the team of doctors, pharmacists, techs, nurses, infection preventionists, microbiologists, and data analysts at Roper St. Francis tasked with tackling the problem. Everyday the group reviews patient charts and identifies bacterial cultures present in Roper St. Francis hospitals by way of regular testing. "By staying abreast of the specific strains on site from day to day, we can make smarter decisions about when to use different types of antibiotics," says Utley. They can ensure that patients with nonresistant bacterial infections are given narrow-spectrum antibiotics, while saving broad-spectrum antibiotics for more aggressive, antimicrobial-resistant infections. Their efforts have worked: 10 years into this focus on antimicrobial stewardship, doctors and pharmacists at Roper St. Francis have been able to continue using many antibiotics that are less effective elsewhere in the country. And recently, the Infectious Diseases Society of America dubbed the hospital system an Antimicrobial Stewardship Center of Excellence. Dr. Kent Stock

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