Study finds county near top in potentially avoidable prescriptions

The Centers for Disease Control and Prevention has scheduled a campaign that starts Nov. 14 called Get Smart About Antibiotics Week to raise awareness of the overuse of antibiotics, which helps bacteria evolve into resistant “super bugs.”

“Antibiotics can’t help a patient who has come down with the flu,” noted Dr. Michael Nesheiwat, Putnam County’s interim commissioner of health. “The flu is a viral infection. Antibiotics are only helpful with bacterial infections. People need to understand the difference.”

This popular misconception is familiar to Nesheiwat, who has run a family medicine practice for 25 years. “Sometimes patients just want a prescription—something they think will make them better. This is why the health department has been helping physicians educate their patients by providing doctors with more information, posters and a new type of prescription pad. The pad gives physicians a place to check the appropriate diagnosis—cold, cough or the flu, and clearly spells out the best medicines—simply fluids, saline nasal spray and throat spray.” Older children or adults can also use lozenges for sore throat relief.

Medical illustration of methicillin-resistant Staphylococcus aureus (MRSA) (CDC) 
Medical illustration of methicillin-resistant Staphylococcus aureus (MRSA) (CDC)

According to the New York State Department of Health, Putnam County’s overprescribing rates may be among the highest in the state. It includes Putnam among 11 counties with the uppermost rates of potentially avoidable antibiotic prescription — with 55 to 64 percent of adults filling a prescription after an upper respiratory infection diagnosis, such as a cough or cold. Most other counties fall in the lower two ranges, either 35 to 44 percent or 45 to 54 percent.

Another problem is  prescribing the wrong antibiotic. An October report released from the CDC and Pew Charitable Trusts described the typical pattern for ear and sinus infections and sore throats. They found that 52 percent of patients were given the recommended “first-line” medication, while the remainder received a broad-spectrum antibiotic, which is not necessary and increases drug resistance.

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Surprisingly, adults are much more likely than children to receive the wrong antibiotic. The report found more than 60 percent of adults diagnosed with strep throat were prescribed an antibiotic not recommended by medical guidelines. Only 40 percent of children faced the same situation.

“The public health implications of this situation are huge and not confined to New York or even just the U.S,” Nesheiwat said. “In fact, global health experts have warned that by the year 2020, super-bugs may kill more people than cancer kills today. These are truly scary numbers.

“Unfortunately, there isn’t a simple solution,” he said. “But we have to start with what we can do, and informing the public, as well as health care providers, is that first step.”

For more information about Get Smart About Antibiotics Week, visit cdc.gov/getsmart.

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