Experts: Antibiotic Stewardship Starts with Providers, Patients


Health experts say reaching for an antibiotic when something like the common cold strikes might not be the best first move.

Infectious disease experts shared some of the latest research at a symposium in Kearney sponsored by Good Samaritan Hospital, Creighton University, and the University of Nebraska Medical Center.

Around 250 physicians, physician assistants, nurses, nurse practitioners, and pharmacists from around the region were told that while sometimes antibiotics are the answer, some doctors believe that too often they're being prescribed too soon.

Dr. Angela Hewlett, an assistant professor in the Division of Infectious Diseases at UNMC, says a big topic in the field right now is called "antibiotic stewardship."

"Antibiotics are the only drugs that how I use that drug actually affects your patient," says Hewlett.

Viruses and bacteria that lead to things like the cold or flu naturally change and become resistant to antibiotics. But Hewlett and others say that resistance is happening faster, partly because antibiotics are prescribed early in an infection when a patient's own immune system and over-the-counter remedies could fight it off.

"That doesn't mean antibiotics aren't indicated and they may well be indicated, but early usage in a common cold is overuse of antibiotics and leads to antimicrobial resistance," says Dr. Bill Vosik, chairman of the Department of Education at Good Samaritan Hospital.

Doctors say the problem is causing the nation's antibiotic supply to dwindle, and it's not being replaced fast enough.

They say fewer drug companies make antibiotics because they have to be changed to defeat that resistance, so they aren't as profitable as something like blood pressure medication that more people take for longer periods of time. They say getting a new antibiotic approved is a slow process as well.

"What this really means is choosing the right drug in the right dose at the right time and using it for the duration of treatment," says Vosik.

Hewlett says becoming better stewards of the drugs means educating providers and the public.

"I can preach all day about the overuse of antibiotics, but the people who really need to understand that are the people who see these patients first line," she says.