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Combating antibiotic resistance: Medicine enlists community awareness

Physicians are central to efforts that mobilize communities against the misuse of these valued infection fighters.

Editorial. Dec. 23/30, 2002.

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There have been clear warning signs of a crisis ahead in combating infection. For almost a decade, high rates of antibiotic use have paralleled reports of emerging antimicrobial resistance.

As recently as October, a Centers for Disease Control and Prevention communiqué detailed a case of vancomycin-resistant Staphylococcus aureus in Pennsylvania. A similar case earlier this year in Michigan also proved resistant to vancomycin, the drug of last resort for many infections.

If this weren't enough, additional data indicate growing resistance to another high-tier infection fighter, ciproflaxin. Among other trouble signs is that Streptococcus pneumoniae bacteria are now more than 35% penicillin-resistant -- which means physicians will face limits in treatment options for at least one in three patients with this type of infection.

These facts are disturbing. They are also the reason that the AMA has long focused on raising physician awareness about the dangers of inappropriate antibiotic prescribing and has armed doctors with tools to educate their patients about appropriate use. On that point, there is some recent good news.

It comes from an analysis of data from the National Ambulatory Medical Care Survey, published in the June 19 Journal of the American Medical Association. The report found that the rate of antimicrobial prescribing overall and for respiratory tract infections by office-based physicians for children and adolescents younger than 15 decreased significantly between 1989-1990 and 1999-2000. This represents a change from 1980 to 1992, when the rate jumped 48%. [...]