lAMA Patient Page I August 19,2009

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Eilsl~rn ShOI';;> H~nll.h Cen .f', LtC908 Pi,1.illUllon BlvG.1:.11rhope, A L 36332Inappropriate Use of Antibiotics

Carolyn 1. Hildreth, MD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, EditorJAMA. 2009;302(7):816. doi: 10./001Ijama.302. 7.8/6.

An antibiotic is a substance produced naturally by microorganisms orsynthetically by chemists in a laboratory. Antibiotics are capable of inhibiting thegrowth of or killing bacteria (a particular class of germs). A Nobel Prize wasawarded to Alexander Fleming for his discovery of penicillin in 1928. However, itwasn't until 1941 that penicillin was successfully produced for commercial use, in time to treat infections in soldiersinjured during World War II. Since then many new antibiotics have been discovered and produced. Most have a limitednumber of the types of bacteria that they can inhibit or destroy. Other antibiotics are broad spectrum, meaning they candestroy many types of bacteria. Antibiotics should be used only for bacterial infections and are not effective against theviruses that cause many illnesses including influenza and most upper respiratory tract infections, including the commoncold, or fungal infections like those caused by yeast. The inappropriate use of antibiotics for these types of infections aswell as the more frequent use of broad spectrum antibiotics has caused the emergence of newer strains of bacteria that areresistant to many antibiotics. The August 19,2009, issue of JAMA includes an aliicle about use of antibiotics in acuterespiratory illness.

THESE INFECTIONS CAN USUALLY BE TREATED WITHOUTANTIBIOTICS

• Common cold• Influenza (flu)• Most coughs and bronchitis (chest cold with a cough)• Many ear infections (also called otitis media)• Many skin rashes

INFECTIONS CAUSED BY INAPPROPRIATE ANTIBIOTIC USEBacteria like Staphylococcus aureus (a bacterium that causes serious infections in immune compromised persons)

develop resistance to the antibiotics typically used to treat the infections they cause, leading, for example, to methicillin (atype of antibiotic)-resistant Staphylococcus aureus (MRSA), which can now affect individuals in hospitals and in thecommunity and is difficult to treat effectively.

Other bacteria, such as Streptococcus pneumoniae (common cause of men ingitis, blood infections, andpneumonia), are also developing resistance to antibiotics. Multiple drug resistant tuberculosis may occur when an infectedperson does not complete the several months-long antibiotic regimen needed to cure tuberculosis.

PROBLEMS CAUSED BY RESISTANT BACTERIACommon infections become more difficult to treat and can become life threatening. Infected people often require

longer, more expensive, and more toxic treatment during extended hospital stays. The spread of the resistant bacteria tofamily members, coworkers, and friends threatens communities.

WHAT YOU CAN DO• Take antibiotics only when prescribed to you by a physician.• Follow all directions when taking antibiotics and take the entire prescribed regimen even if you feel better before

finishing them.• Throwaway any unused antibiotics; don't save antibiotics for future use since partial and incomplete treatment

regimens are ways that bacteria develop resistance to antibiotics.• Do not share your medication and don't take antibiotics prescribed for someone else; specific antibiotics are

prescribed for specific bacteria, since all antibiotics are not able to cure all bacterial infections.

Copyright ©20 14 American Medical Association

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