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Antibiotics: From medical miracle to medical nightmare

Consumer Reports is working with the CDC and doctor groups to curb the misuse of these drugs before they stop working

Published: March 04, 2014 01:00 PM

American hospitals are falling short in how they use antibiotics, according to a new report from the Centers for Disease Control and Prevention. That’s bad news, for several reasons. First, antibiotics aren’t harmless: About 20,000 people a year die from complications of the drugs, including severe allergic reactions and diarrhea. Second, misuse of antibiotics breeds superbugs that are resistant to the drugs, making patients vulnerable to life-threatening, hard-to-treat infections. The new CDC report estimates that about a third of the antibiotics used in hospitals could be prescribed better.

It is sobering to see how poorly hospitals perform at such a high-priority task. But hospitals alone aren’t to blame. For example, doctors—citing cherished notions of medical autonomy—have long resisted efforts to cut back on using the drugs in their practices.

And for many years drug makers focused on producing ever more powerful “broad spectrum” antibiotics, such as Zithromax—and then spent millions of dollars persuading doctors and patients that they needed those powerful drugs. In fact, though, those medications should have been reserved for the hardest-to-treat infections, and their misuse has fueled the growth of antibiotic-resistant bacteria.

Now that most antibiotics are available as low-cost generics, the drug companies have moved on to creating other overuse problems (such as giving men the impression that they all have low testosterone). And many of them, including Pfizer,  are pouring antibiotics into livestock, a practice that has minimal benefits but leads to the same problem it does in humans: superbugs. (Read more about the dangers posed by using antibiotics in healthy animals.)

What’s being done to address the problem? Several things.

First, the CDC recently urged hospitals to prescribe and administer antibiotics more carefully and to track and prevent hospital-acquired infections more vigorously. And physicians are finally acknowledging their overuse and misuse of antibiotics. As part of a program called Choosing Wisely, which aims to reduce unnecessary and potentially harmful medical care, nearly a dozen medical groups have identified specific situations when antibiotics are often misused. Those including prescribing antibiotics for the common cold, sinusitis, and ear infections. Consumer Reports has worked with those medical groups to produce consumer-friendly summaries explaining why the drugs usually aren’t necessary for those health problems.

So what can we conclude? The health care industry has not served consumers well when it comes to antibiotics. Miracle drugs from 60 years ago have become a daily threat to tens of thousands of consumers. Regulation by voluntary “stewardship” approaches are a start but are likely insufficient to solve problems in hospitals we expect to be safe. Market regulations have failed to make drug companies moderate their marketing messages. They need to. And if hospitals are to become safe again, then need to get much tougher on a daily basis with their staff, especially the doctors. It won’t be easy.

John Santa, M.D., M.P.H.

Director, Consumer Reports Health Ratings Center

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