All must fight in war against mutating germs

Thursday, June 24, 1999

It will take the work of patients, doctors to keep antibiotics viable.

By Ron Sylvester

In the battle between humans and germs, the germs are winning.

The war is still up for grabs, however, and human victory could mean obeying a simple axiom: Stop depending on antibiotics.

That’s not as easy as it sounds. Doctors and public health officials in Springfield are mapping out strategies to persuade an entire community not to expect the magic pills they’ve relied on for years.

All that, however, means changing long-held attitudes.

“You try to go out and teach the public and physicians … it’s really a whole different ball of wax,” said Dr. Bernadette Albanese of Johns Hopkins University.

In Baltimore, Albanese directs one of a handful of community projects in the United States that are educating people on antibiotic misuse.

The “Use Antibiotics Wisely” program has been in place for more than a year, teaching judicious use of antibiotics through multimedia campaigns, physician workshops and seminars at day-care centers and PTA meetings.

Some doctors might expect a backlash of public wrath for not dishing out medicine on demand, but that hasn’t happened in Baltimore.

“The response from the public has been overwhelming,” Albanese said. “Once you explain it to them, people really seem to jump on the bandwagon.”

A lack of money and exposure, however, creates hurdles.

“You don’t have oodles and oodles of state monies and federal monies just pouring into this because it’s a sexy new health topic. We’re scrambling,” Albanese said. “We’ve got 2Ï million people in the Baltimore metropolitan area, but we’re getting a smattering of that with the program. It needs to become very common.”

The Springfield-Greene County Health Department and county medical society have joined forces to try a similar approach in Springfield.

St. John’s Health System physicians have already started handing out pamphlets on antibiotic use in some doctors’ offices and at pediatric clinics.

And a task force of doctors and health professionals is exploring ways to get the word out citywide.
Suggestions have ranged from including information in utility bills to mailings with insurance statements and through local pharmacies.

The federal Centers for Disease Control and Prevention has agreed to help local officials with educational materials.

“As a community, we’re kind of on the cutting edge of this,” Health Director Harold Bengsch said.

The hope is that by fall, doctors will be writing fewer prescriptions for patients less insistent on getting them.

To succeed, experts say people will have to stop assuming antibiotics are the pills to cure all their ills.

That means altering habits that have become ingrained in the public psyche for a half-century since the arrival of penicillin.

“You’re not going to change practices overnight,” said Dr. Wolfe Gerecht with Cox Health Systems. “It took years to create these people. Now, we’ve got to de-create them.”

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What you can do to ensure the correct use of antibiotics:

·Know what antibiotics treat: Most infections come from two types of germs: bacteria and viruses. Viruses cause most coughs, sore throats and all types of colds and flu. People recover when the virus runs its course. In the meantime, over-the-counter products can provide relief from symptoms. Antibiotics stop bacteria from growing in places like the throat, lungs, ears and intestinal and urinary tracts.

Bottom line: Antibiotics are useless against viruses.

·Know the proper uses for your prescription: Discontinuing medicine or not using it as directed can increase chances of developing organisms resistant to the drugs. These stronger microbes can then be passed to family and friends.
Bottom line: Take antibiotics in proper doses and for the length of time you’re told.
·Avoid self-diagnosis and home remedies: Different viruses and infections may cause similar symptoms. Don’t assume a medicine that helped an earlier ailment will work on what you have now, or on another person.

Bottom line: Do not take old medicines or share them.

·If you think you need an antibiotic, arrange an office visit: A bacterial infection needs to be checked for severity by a professional.

Bottom line: Do not demand antibiotics or ask for a prescription by phone.

Regional reach
Samples of bacteria tested for drug resistance come to Springfield’s two major hospital laboratories from across the Ozarks.

·St. John’s Health System has doctors and clinics in 23 counties.

·Cox Health Systems covers patients in 18 primary counties.