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Americans are taking antibiotics that are unnecessary and potentially harmful, according to a recent report from the Centers for Disease Control and Prevention.
The report evaluated antibiotic overuse nationwide, using information from 17 studies conducted between 2000 and 2016. It found that doctors regularly overprescribe medication for patients they see in office visits, hospitals and nursing homes. They also frequently prescribe too many doses and the wrong types of antibiotics, such as powerful broad-spectrum drugs rather than more-targeted ones.
"All antibiotics can have serious side effects, so when they are used inappropriately it's all risk and no benefit," says Marvin M. Lipman, Consumer Reports' chief medical adviser. "And every time an antibiotic is used, whether its use is indicated or not, there is always a chance of causing bacterial resistance so that it becomes useless in the future."
Outpatient settings (medical and dental offices, emergency departments, urgent-care clinics): Here, the CDC offers a bit of good news. Between 2011 and 2014, antibiotic prescriptions written in doctor's offices and clinics dropped by 5 percent. "There has been a concerted effort over a number of years to really reduce antibiotic use for colds, coughs and illnesses that don't require antibiotics," says Lauri Hicks, director of the CDC's Office of Antibiotic Stewardship.
But still, in 2015, one-third of antibiotic prescriptions dispensed from pharmacies outside hospitals were unnecessary. Most were given to people with upper-respiratory conditions, which are often viral; antibiotics are effective only against bacterial infections.
Hospitals: Despite the CDC's push to reduce antibiotic overuse in hospitals, half of hospital patients still receive antibiotics.
Also concerning is that doctors are writing more in-hospital prescriptions for very potent antibiotics rather than more-conservative ones. This can lead to serious, potentially deadly infections such as carbapenem-resistant enterobacteriaceae (CRE) and Clostridium difficile (C. diff).
Nursing homes: Although there's less research on antibiotic use in eldercare facilities, the CDC report found that up to 75 percent of such prescriptions given to people in nursing homes are inappropriate. According to data from early 2014, 11 percent of U.S. nursing home patients, who may be at greater risk of C. diff, are taking antibiotics on any given day.
These steps will help safeguard against antibiotic overuse:
●Get antibiotics only when you need them. If the doctor recommends an antibiotic, ask whether it's necessary and whether the drug is the first-line treatment for your illness.
●Be wary of fluoroquinolones. These powerful medications can have dangerous side effects, including permanent, disabling damage to the central nervous system, muscles, joints and nerves. If your doctor prescribes a fluoroquinolone, such as ciprofloxacin (Cipro and generic) and levofloxacin (Levaquin and generic), for common infections such as bronchitis, sinus infections and urinary tract infections, question it.
In a nursing home:
●Question whether you or your relative need an antibiotic, if one is prescribed. Staff shouldn't test for or treat a urinary tract infection unless symptoms such as frequent, bloody or cloudy urination, pain during urination, or fever are present.
●To avoid spreading bacteria, insist that staff members wash their hands before they touch you or your loved one.
In a hospital:
●Ask whether the antibiotic your doctor wants to prescribe is the first-line treatment for your condition. Fluoroquinolones can make people especially prone to a C. diff infection.
●Insist that hospital staff members wash their hands when they enter your room and that the room is cleaned if it looks dirty.
●Bring disinfectant wipes for commonly touched objects, such as doorknobs and the TV remote.
●Ask daily whether a catheter and other tubes, such as those for a ventilator, can be removed. These increase your risk of serious infection.
●If you have to be shaved, request that staff use an electric shaver rather than a razor. Razor nicks can provide an opening for bacteria.
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