otitis media prescriptions

Concern over Antimicrobial Resistance is Growing

Three years ago the Centers for Disease Control (CDC) created a list of the 18 antibiotic-resistant microbes threatening the health of Americans. Given the relatively high prevalence of otitis media in children, which is often treated with antimicrobial drugs, the rise of antibiotic resistance is a cause for concern among healthcare professionals.

Antibiotic-resistant infections affect two million people and are associated with 23,000 deaths annually in the United States, according to a May 2 report from the CDC. Further, the CDC found that the number of cases of sepsis, a life-threating condition, rose from 621,000 in 2000 to 1,141,000 cases in 2008. The CDC believes this dramatic rise in sepsis is attributed to the emergence of MRSA – a variety of the Staphylococcus aureus bacteria that is now often resistant to commonly prescribed antibiotics.

Science Daily recently reported on the work of Katherine E. Fleming-Dutra, M.D., of the Centers for Disease Control and Prevention, Atlanta, and colleague,who used the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis. The research team estimated portions of antibiotic use that may be inappropriate in adults and children in the U.S.

 

Of the 184,032 sampled visits, 12.6 percent of visits resulted in antibiotic prescriptions. Sinusitis was the diagnosis associated with the most antibiotic prescriptions, followed by suppurative otitis media, and pharyngitis (sore throat). Collectively, acute respiratory conditions per 1,000 individuals in the population led to 221 antibiotic prescriptions annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions.

Prescriptions Found to be Inappropriate

 

flem
Katherine Fleming-Dutra, M.D.

“Half of antibiotic prescriptions for acute respiratory conditions may have been unnecessary, representing 34 million antibiotic prescriptions annually. Collectively, across all conditions, an estimated 30 percent of outpatient, oral antibiotic prescriptions may have been inappropriate. Therefore, a 15% reduction in overall antibiotic use would be necessary to meet the White House National Action Plan for Combating Antibiotic-Resistant Bacteria goal of reducing inappropriate antibiotic use in the outpatient setting by 50 percent by 2020.” said Dr. Fleming-Dutra.

This week marks the publication of the final recommendations of a review on resistance to antimicrobial drugs, called the O’Neill report.

The report is sponsored by the British government and Wellcome Trust, a medical charity. Its chief author is Jim O’Neill, former chief economist at Goldman Sachs. According an earlier report from the group, 700,000 people die each year worldwide from infection caused by antimicrobial drug resistance.

 

The report suggests antibiotic resistance is a real threat to the global economy over the next 30 to 40 years, as an estimated 10 million people may be susceptible to antimicrobial drug resistant condition that could result in death with an associated hit to the global GDP of 2 to 4%.

 

The report also indicated that the American healthcare spends more than $20 billion per year dealing with the effects of antibiotic resistance.

Among the solutions for curbing antibiotic resistance mentioned in a recent Economist article include increasing government investment in the creation of more effective antibiotics, promoting greater adherence to recommended childhood vaccinations, and banning antibiotics use in farm animals. Perhaps the most promising breakthrough is a test that deciphers the difference between a viral and bacterial cause of common human illness. Although this test is not yet commercially available, experts are optimistic that it will be approved for use in a few years. For the child and parents suffering from the effects of otitis media, such a diagnostic test could not come soon enough.

 

*title image courtesy americanpregnancy.org