When our throats burn, we’re conditioned to reach for antibiotics. When our noses run, we hound doctors for antibiotics. When we’re too groggy to drive to the doctor, we search our medicine cabinets for leftover antibiotics.
“We need a total culture change,” said Jesse Goodman, director of Georgetown University’s Center on Medical Product Access, Safety and Stewardship and a former FDA chief scientist. “Patient and doctor must understand these drugs are precious resources. The more we use them, and the more unwisely, the more resistance.”
President Obama announced a plan this week to nearly double the amount of federal funding dedicated to fighting antibiotic-resistant bacteria, a national health threat the CDC says annually causes an estimated 2 million illnesses and 23,000 deaths. The president will ask Congress for $1.2 billion as part of his annual budget request. Funds would be used to hasten the development of antibiotics and diagnostic tools, heighten surveillance for “superbugs” and curb the spread of antibiotic-resistant microbes in medical settings.
The proposal follows the White House’s five-year plan, which last year ordered federal agencies to escalate efforts to “to better protect our children and grandchildren from the reemergence of diseases and infections that the world conquered decades ago.”
Our overuse might be a branding problem. Antibiotic-resistant bacteria is a plight triggered by overuse. And overuse is driven partly by a pervasive belief that the drugs can conquer all. It started nearly a century ago.
Alexander Fleming, a Scottish biologist, discovered penicillin in 1928 and, with it, effective treatment for pneumonia, gonorrhea and rheumatic fever. Advertisements in the 1940s and '50s intensified our growing affection. One popular public health sign declared: “Penicillin cures Gonorrhea in four hours!” Another brand of antibiotic "candettes" promised “immediate, soothing relief” to sore throat sufferers.
“They were seen as safe, miracle drugs with few side effects,” Goodman said. “It got out of hand.”
Pharmaceutical companies today are less outwardly aggressive about peddling antibiotics. “But in some cases,” he said, “marketing can promote an antibiotic as powerful and reliable and, anecdotally, lead people to perhaps reach for it when an older or less broadly active one would have worked.”
The result: Slowly and surely, we’re weakening our miracle drugs. The first step to recovery is to stop thinking they’re dispensable.
About 36 percent of Americans incorrectly believe antibiotics can fight viral infections, a recent Pew survey found. The drug can treat only bacterial ailments, like strep throat and urinary tract infections and a range of sexually transmitted diseases.
We can’t banish upper respiratory infections, for example, with antibiotics. Coughs and colds are generally caused by viruses. But as many as 50 percent of people who visit their doctor’s office for an infection, even for a runny nose, will walk out with an antibiotic, the CDC reports.
And a recent survey by Harvard researchers found doctors prescribed antibiotics to 60 percent of sore throat patients, though the drug is thought to be necessary in only 10 percent of cases. A whopping 73 percent of patients diagnosed with acute bronchitis -- best treated with ibuprofen and a humidifier -- received unnecessary antibiotic prescriptions.
Some researchers blame decision fatigue: Doctors are much more likely to prescribe needless antibiotics to a patient with an acute respiratory illness if the visit is scheduled during the end of a clinic shift, a study published in JAMA Internal Medicine found.
Many are reluctant to wait out the malaise, though some physicians recommend giving an illness time to clear up on its own. This is a society of immediate gratification, raised on rose-colored tales of antibiotics.