Physicians key to slowing the rise of antibiotic resistance

Patient and physician education combined with programs that guide physician decision-making are found helpful in reducing inappropriate prescribing of antibiotics.

By Susan J. Landers, AMNews staff. July 16, 2007.

Washington -- It's not that the warnings about antimicrobial resistance are new. Consider this admonition from Sir Alexander Fleming in his 1945 Nobel lecture: "It's not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body."

Despite this cautionary advice given decades ago and the mounting evidence that microbes are indeed becoming resistant to even the latest antibiotics, physicians are still prescribing these agents in circumstances for which they are of no use. And many patients continue to seek these drugs believing that they are the long-sought cure for the common cold.

The increase in the number of pathogens that are proving stronger than any of the more than 100 antibiotics in a physician's toolbox are fueling fears that the amazing public health advance that was begun with the discovery of penicillin will ultimately be defeated.

But perhaps office-based physicians can at least help slow the rise of these resistant bugs, suggested Jeffrey Linder, MD, MPH , an internist at Brigham and Women's Hospital in Boston. He spoke at a conference on antimicrobial resistance held June 25-27 in Bethesda, Md., sponsored by the National Foundation for Infectious Diseases.

Acute respiratory infections are the most common reason for millions of ambulatory care visits. In about 50% to 75% of cases, antibiotics are prescribed -- many inappropriately, said Dr. Linder.