Overprescribed: The problem with antibiotics

Doctors not farmers are to blame.

From a British Medical Journal media release:

Alarming pattern of antibiotic use in the southeastern United States

Trend data follows release of first-of-its-kind ‘drug resistance index’ for superbugs

Washington, D.C.– New research suggests a pattern of outpatient antibiotic overuse in parts of the United States– particularly in the Southeast –a problem that could accelerate the rate at which these powerful drugs are rendered useless, according to Extending the Cure, a project of the Center for Disease Dynamics, Economics & Policy.

These findings come out just as the Centers for Disease Control and Prevention (CDC) kicked off an annual effort to reduce overuse of antibiotics called “Get Smart: Know When Antibiotics Work.” The campaign, which lasts throughout the week, urges Americans to use antibiotics wisely. The CDC estimates that $1.1 billion is spent annually on unnecessary antibiotic prescriptions for adult upper respiratory infections alone. These prescriptions also speed the development of resistance to important antibiotic therapies.

Also, on Monday of this week, Extending the Cure introduced a new tool that allows non-experts to track changes in antibiotic effectiveness over time. The new Drug Resistance Index (DRI) is similar in concept to the Consumer Price Index and is described in a paper in the British Medical Journal Open.

Trends in Antibiotic Use Paint a Troubling Picture

Interactive maps released by Extending the Cure track antibiotic use in the United States from 1999 to 2007 and show how overall antibiotic dispensing has decreased; consumption fell by about 12% over this time period. However, they also highlight alarmingly high antibiotic use across the Southeast compared to states in the Pacific Northwest. For example, residents of West Virginia and Kentucky, where antibiotic use rates are highest, take about twice as many antibiotics per capita as people living in Oregon and Alaska.

Additional key findings include:

  • The five states with the highest antibiotic use in the nation are West Virginia, Kentucky, Tennessee, Louisiana and Alabama. However, the maps show higher than average use of antibiotics in other regions of the country as well. Check your state’s antibiotics use at ResistanceMap.
  • Prescribing rates for a powerful class of antibiotics known as fluoroquinolones shot up by 49 percent from 1999 to 2007. At the same time, antibiotic resistance is increasing: these drugs are now seven times less likely to work against Escherichia coli, the most frequent cause of bacterial infections, than they were in 1999.
  • Penicillins remain the most popular antibiotics — accounting for nearly one out of three prescriptions filled in the United States. At the same time, the market share of these standard drugs has declined by 28 percent as physicians increasingly turn to more powerful antibiotics.

High per capita antibiotic use rates could reflect an environment in which consumers mistakenly demand antibiotics – and physicians prescribe them — when they have a cold or the flu, which are caused by viruses and cannot be treated with these drugs. However, additional research must be done to better understand the driving factors behind antibiotic use.

The data was released today as part of Extending the Cure’s ResistanceMap, an interactive web-based tool that tracks drug resistance.

This reality is typically ignored by enviros who want the public to think that farmers are to blame for antibiotic resistance.

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