By: Yvette Morrison, PharmD, FASHP
It’s been almost 95 years since the discovery of penicillin by Alexander Fleming, which revolutionized 20th century medicine. This discovery and the “dawning of the antibiotic era” happened almost by accident when Fleming observed a common Staphylococcus aureus bacteria were killed by a mold that produced a substance that could essentially dissolve it. He named the substance penicillin. Penicillin was hailed as a miracle drug during World War II, when it was widely effective for treating battlefield wound infections of soldiers. This beginning success spawned more discovery and production of other antibiotics that have contributed to historic improvements in human health and life expectancy.
Unfortunately, not long after penicillin became commercially available, its success was weakened by an event known as antibiotic resistance. Antibiotic resistance is a naturally occurring process because bacteria are constantly finding ways to outsmart the drugs (antibiotics) designed to kill them. Any use of an antibiotic can contribute to the development of resistance as it allows the bacteria to “see” what the antibiotic “looks” like once exposed to it. Think of antibiotic resistance like a crafty disguise bacteria can put on to make themselves unrecognizable to the antibiotic thereby allowing it to survive.
Over time, the problem of antibiotic resistance has become a public health concern as it involves many more bacteria and antibiotics than just Staphylococcus aureus and penicillin. Too many antibiotics are being used unnecessarily. In fact, the Centers for Disease Control and Prevention (CDC) estimates that approximately 30% of all antibiotic courses prescribed in American doctor’s offices and emergency rooms each year are for viral infections that don’t need antibiotics. Antibiotic misuse is not only a function of whether or not it’s for the RIGHT diagnosis, meaning it is for a bacterial not viral infection, but is also determined by how it is used when actually diagnosed. Other components, such as prescribing the RIGHT antibiotic at the RIGHT dose for the RIGHT duration, can also be contributing factors.
Everyone has a role to play in ensuring antibiotics are used appropriately by checking their “antibiotic IQ” against the list of RIGHT’s by scanning the following QR code. The table provides some commonly encountered respiratory infections and guidance as to which ones are RIGHT for antibiotic therapy as a sample initial step of the checklist. Combating antibiotic resistance by holding unnecessary antibiotic use and misuse in “check” can preserve the life-saving potential of these important medications. It will help us avoid progressing into an era of currently treatable infections that would become more difficult to treat, if they can be treated at all.