Antimicrobial Resistance: The Big Picture

An Interview With CDC's Steven L. Solomon, MD

Laura A. Stokowski, RN, MS; Steven L. Solomon, MD

Disclosures

September 16, 2013

Editorial Collaboration

Medscape &

In This Article

Helping Clinicians Say No to Unnecessary Treatment

Medscape: Another core action is antibiotic stewardship, something that clinicians have heard a lot about. They know the right thing to do but have trouble implementing it. What can clinicians do differently?

Dr. Solomon: In this report, we try to give clinicians better tools for dealing with this problem. Antibiotics are a unique class of drugs. We use antibiotics in ways that we would never use any other type of drug. They are life-saving. It's hard to think of another drug where the effect is so immediate and so profound. Antibiotics are precious resources that must be conserved so that they continue to be useful in treating the sickest patients.

There are many guidelines about using antibiotics as quickly as possible when there is a risk for infection. We have to be very careful that at no time do we ever discourage the proper use of antibiotics. We have great faith in the clinical acumen of clinicians and we are trying to give them better tools to diagnose infections and identify antibiotic resistance. Better diagnostic tests will help immensely in making sure that clinicians are able to prescribe the right drugs and use them only when they are needed and only in the most appropriate way.

We are looking at how we can engage not just the health professional community but consumers as well. We are trying to make the case, as with any drug, that antibiotics are not without risk. There are allergic reactions, side effects, and significant drug-drug interactions. We want to give clinicians the ammunition and information that they can share with their patients to help patients understand why antibiotics should not be taken when they aren't needed.

Our goal is to shine a bright spotlight on the big picture of antibiotic resistance and get everybody engaged to help clinicians do their jobs. We are convinced that doctors want to do the right thing. They want the best for patients, and we are doing everything we can do to help them.

Medscape: The report mentions the CDC's Get Smart About Antibiotics program. Has the program made a difference in antibiotic prescribing?

Dr. Solomon: Yes, although it takes time. The Get Smart program was launched in 2003. Over the ensuing decade, we have seen an overall 24% decline in the prescription of antibiotics for children under the age of 14 years, which was one of the early focus areas of the Get Smart program. We have seen improvements in antibiotic prescribing practices and a reduction in the number of antibiotics prescribed when they are not needed. We are collecting data now that preliminarily suggest that we may be seeing a similar pattern in the prescription of antibiotics for adults in outpatient settings.

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