Appropriate Use of Antibiotics

Antibiotics can only treat illnesses caused by bacteria. However, there is a common misconception that they can also treat viral conditions, such as colds, bronchitis, and flu. This miseducation of the public, surrounding the use of antibiotics, in addition to improper prescribing from physicians, has lead to increased antibiotic resistance in the population, which threatens to reduce the efficacy of antibiotics, which could render them ineffective against common infections, making them much more threatening to public health.

The World Health Organization (WHO) defines the appropriate use of antimicrobials as “the cost-effective use of antimicrobials which maximizes clinical therapeutic effect while minimizing both drug-related toxicity and the development of antimicrobial resistance”. Observing the proper use of antibiotics is vital to addressing the threat of antibiotic resistance, which is deemed to be one of the most urgent threats to global health.

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Increasing antibiotic resistance

Increasing antibiotic resistance threatens global health, food security, and economic development. Antibiotic resistance impacts all global regions and populations. While it is a process that happens naturally, inappropriate use of antibiotics accelerates the process, resulting in reducing the efficacy of antibiotics, which causes common infections to become more serious and persistent.

Several infections, in particular, have become significantly impacted from improper antibiotic use, including gonorrhea, pneumonia, salmonellosis, and pneumonia. As a result, patients are hospital stays, medical costs, and mortality is increasing.

In some global regions, antibiotic resistance is rising particularly fast, with resistance mechanisms emerging and spreading rapidly through the population. The threat to human health is very real, and global health agencies are calling for the enforcement of the appropriate use of antibiotics to reduce the speed at which antibiotic resistance is increasing. Here, we discuss the proper use of antibiotics that should be followed by physicians and patients.

Proper use of antibiotics

An increasing amount of evidence is emerging, revealing the extent of the improper use of antibiotics in the treatment of a wide range of illnesses. For example, studies have shown that more than half of prescribed antibiotics are not necessary, demonstrating the widespread improper prescribing of antibiotics by physicians.

An example of where physicians are failing to prescribe antibiotics correctly is in terms of treating via infections. With some infections, either bacteria or a virus may be responsible, therefore, physicians must recognize how to determine the underlying cause to avoid prescribing antibiotics for a viral condition, which occurs in an estimated 50–80% of patient’s who likely have a viral rather than a bacterial infection.

Pharyngitis is one of the most commonly misprescribed conditions, with more than 80% of cases that display a viral etiology being prescribed antibiotics. Another example is the treatment of Otitis media in children, where antibiotics are often prescribed even when the benefits do not outweigh the drawbacks of the common adverse events.

Scientists recommend that there is a need for a greater emphasis on physicians doing due diligence to ensure they are only prescribing antibiotics where required, particularly, not prescribing them for conditions that are likely caused by viruses. Additionally, they stress that there is a need to educate the public on the proper use of antibiotics, to prevent them from seeking prescriptions of antibiotics when they are not necessary.

There are several common scenarios when antibiotics are prescribed unnecessarily, if the public and physicians could be alerted to these common inappropriate uses, it could limit the extent of inappropriate use and help put the brakes on the accelerating rates of antibiotic resistance. These common inappropriate uses include the prescription of antibiotics for fever in the absence of symptoms of infection, bacterial infections that are usually self-limiting (diarrheal diseases, for example), asymptomatic bacteriuria (except in pregnant women), and asymptomatic colonization of skin ulcers, sores, and wounds.

Antibiotics are also commonly sought after for illnesses that are caused by viruses rather than bacteria such as colds, sore throats (with the exemption of strep throat), flu, and many cases of chest colds. Additionally, some common bacterial infections do not usually require antibiotics although they are often prescribed for them, such as sinus infections and some ear infections. As a rule of thumb, antibiotics should only be prescribed to treat certain bacterial infections, such as strep throat, whooping cough, and urinary tract infections (UTIs), amongst others.

Moving forward to prevent antibiotic resistance

There is an urgent need to enforce the proper use of antibiotics to fight accelerating antibiotic resistance among the population. Individuals can help these efforts by only using antibiotics as prescribe and not demanding antibiotics if a physician has deemed them unnecessary. Policymakers can help by initiating national strategies to tackle antibiotic resistance as well as to enhance surveillance of antibiotic-resistant infections and promote the appropriate use of antibiotics.

Finally, healthcare professionals have a duty to only prescribe antibiotics when necessary, educate patients on how to take antibiotics properly, and encouraging patients to engage in behaviors that prevent infection, such as proper handwashing, vaccinations, and practicing safe sex.

Antibiotic Resistance. Image Credit: Lightspring/Shutterstock.com

Written by

Sarah Moore

After studying Psychology and then Neuroscience, Sarah quickly found her enjoyment for researching and writing research papers; turning to a passion to connect ideas with people through writing.