CDC takes "Get Smart" message to consumers: Antibiotics won't cure flu

Some patients believe antibiotics cure everything. A new campaign reinforces physician efforts to use these medicines appropriately.

Editorial. Oct. 27, 2003.

Snort. Sniffle. Sneeze. But no antibiotics please.

That's the message of a new national consumer education program to make Americans more aware of when antibiotic treatment is warranted.

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The AMA wants the public to hear this message.

With flu season fast approaching, it is imperative that patients understand when these germ fighters will work and when they won't. That's why this initiative -- the Get Smart campaign -- was launched last month by the Centers for Disease Control and Prevention with support from the AMA, American Academy of Family Physicians, American Academy of Pediatrics and other health organizations.

Over the last decade, almost every type of bacteria has become increasingly resilient against antibiotic treatment -- mostly because these vital medicines are being used when they are not needed. Now more than ever, the watchwords that patients must understand and that physicians must enforce are "judicious use."

Physicians already know that antibiotics are not an effective treatment for viruses, such as those that cause cold and flu, and that inappropriate use -- particularly among children -- is contributing to an alarming growth of antibiotic resistance. And they have taken steps to change prescribing habits. For instance, a 2002 Journal of the American Medical Association article found that the rate of antimicrobial prescribing had dropped overall between 1989 and 1990 and 1999 and 2000.

Still, according to the CDC, tens of millions of these prescriptions are written. Doctors cite diagnostic uncertainty, time pressure and patient demand as the primary reason.

It's a challenge faced regularly. People succumbing to the flu's misery don't always accept the doctor's explanation that antibiotics won't make them better. Nor do parents of a young child crying with a sore throat. And data clearly indicate that this kind of pressure leads physicians to give in.

The Get Smart campaign will utilize television, radio and print ads as well as public service announcements and comprehensive national, state and local outreach to buttress physicians' position. It will offer, for example, a "prescription for parents" that gives suggested options for addressing flu symptoms. It also offers hints to understanding antibiotic use and provides commonly asked questions and answers about coughs and colds.

It dovetails with ongoing AMA activities. For instance, the AMA long has urged physicians to talk with their patients about antimicrobial therapy, the importance of compliance with the prescribed regimen and the problem of antimicrobial resistance. At the same time, the AMA has been concerned about the emerging crisis of antibiotic resistance worldwide and taken steps on both the national and international level to promote more effective education. Even now, for instance, the AMA is advocating on behalf of legislation pending on Capitol Hill designed to curb antibiotic resistance. Meanwhile, the AMA repeatedly emphasizes to physicians and physicians-in-training the importance of continued vigilance in this regard.

Such AMA efforts include a new year-long educational process currently in development. Its hallmark will be a series of monographs -- some of which feature case studies of physician-patient interaction. The exchange will feature patients who seek antibiotics and the physicians who don't capitulate, but instead explain why this type of treatment would not be useful. Offering physicians this type of model has never been done. The AMA hope, of course, is to provide physicians with tools to help them best say no -- even when the patient is a small child and the parent is pressing hard for such an intervention.

After all, the misuse of antibiotics will lead to harm. But physicians can't combat the problem alone. Their patients have to take to heart the message that antibiotics don't cure all ills and instead cooperate with their doctors' efforts to treat them with the most appropriate course of therapy.

ADDITIONAL INFORMATION:

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Details from the Centers for Disease Control and Prevention about the Get Smart campaign and antibiotic resistance (www.cdc.gov/drugresistance/community)

AMA information about antibiotics and antimicrobials, including a link to the recent report by the Alliance for the Prudent Use of Antibiotics (www.ama-assn.org/ama/pub/physician-resources/medical-science/infectious-diseases/topics-interest/antibiotics-antimicrobials.shtml)