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Tag: Antibiotic-resistant bacteria

  • Will an antibiotic treat your urinary tract infection?

    Will an antibiotic treat your urinary tract infection?

    Pathogens of all types are becoming increasingly resistant to antibiotics. Consequently, simple infections can be hard to treat. Natalie Ma, cofounder of Felix Biotechnology, writes for Stat on the difficulty of finding an antibiotic to treat her all-too-common urinary tract infection, and the side effects she continues to suffer from the antibiotics she took.

    Tens of millions of people get urinary tract infections “UTI’s” each year. Antibiotics at one time treated these infections easily. Now, tens of thousands of people with UTI’s around the world are dying because antibiotics are not able to wipe out these bacteria-causing infections. Rather, we are seeing a rise in antibiotic-resistant bacteria.

    According to the Centers for Disease Control and Prevention, each year, nearly three million Americans are diagnosed with antibiotic-resistant infections. More than 35,000 of them end up dying.

    Ma was first prescribed nitrofurantoin for her UTI, and her symptoms went away. But, only temporarily. Three weeks later, her symptoms returned.

    Ma then took Macrobid. But, it too was not able to kill her urinary tract infection. With the amoxicillin cocktail she next took, she was vomiting and ended up with a yeast infection. Antibiotics often have serious side effects.

    The side effects of the antibiotics Ma took were extremely serious. Ma still had her UTI infection several days later. And, she was in worse physical shape. The antibiotics she had taken had killed off the good microbes in her gut, along with some of the bad ones, leaving the remaining bad ones to prevail.

    It took more than a year for Ma to be cleared of her UTI. And, that was only after being prescribed two other antibiotics. Her face swelled and her throat constricted after taking one of them, forcing her to be hospitalized. The second, cipro, worked well but left her with a sea of rashes and open oozing itchy sores all over her body.

    Ma still suffers from the side effects of the antibiotics she took. It can sometimes still be painful for her to pee and her digestive system has never recovered.  She can no longer digest some basic foods.

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  • Increase in antibiotic resistance affecting older adults

    Increase in antibiotic resistance affecting older adults

    A new study in Clinical Infectious Diseases finds that an increase in antibiotic resistance is affecting older adults, reports Modern Healthcare. The federal government needs to step in and protect older adults from bacterial infections that are drug-resistant.

    In one year alone, 2017, 11,800 people died from antibiotic resistant infections. A large cohort of people spent more than 400,000 days hospitalized in 2017. The cost was $1.9 billion.

    Most of these infections were not hospital-acquired but rather arose in the community. Older adults are especially vulnerable because they are more likely to have compromised immune systems. More than 4,000 older adults died from these infections in 2017, a disproportionately high number.

    According to the Centers for Disease Control and Prevention, each year, nearly three million Americans are diagnosed with antibiotic-resistant infections. More than 35,000 of them end up dying.

    A lot of physicians prescribe antibiotics for conditions that an antibiotic cannot treat.  Overprescribing of antibiotics not only means an unnecessary cost to patients, with some risks, but it also leads to more antibiotic resistant bacteria. One recent study found that 46 percent of urgent care prescriptions were for antibiotics that were not needed to treat people’s condition. Pharmaceutical companies have not been developing new antibiotics to address the pressing need.

    What you should know: According to the CDC, antibiotics only treat infections caused by some bacteria, such as strep throat, whooping cough and urinary tract infections. They are not needed to treat most sinus and ear infections. You should not take antibiotics to treat colds, the flu, most sore throats and bronchitis. Always consult with your doctor if you think medicine is needed to treat your condition.

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  • Hospital care at home

    Hospital care at home

    More hospitals are training their emergency room staff in geriatric care and building geriatric ERs. At the same time, hospitals are increasingly finding ways to provide the kind of inpatient care available in hospital at patients’ homes after an emergency. Essentially, they are bringing the hospital to people’s homes, with support from the Centers for Medicare and Medicaid Services and private foundations.

    The “hospital at home” model relies heavily on technology that once was only available in hospital. Today, testing technology can be transported to people’s homes. In addition, body sensors can track people’s vital signs and transmit their data to doctors at the hospital. And video technology allows patients to have ongoing visual communication with hospital staff from the comfort of their homes.  

    Avoiding a hospital stay can improve people’s health outcomes. The risk of infection from antibiotic-resistant bacteria in hospital can be high. It is also risky to be in a facility filled with sick people who may be contagious. The likelihood of delirium for older patients in hospital is also very high, as they are out of their normal surroundings. My 95-year old father, a former physician, who is otherwise of sound mind, spent one night in a hospital ER and told me the following morning that he could not understand why staff had made him chief of pediatrics.

    Michelle Andrews reports for Kaiser Health News, that Brigham and Women’s Faulkner hospital has established a hospital at home program for patients in stable condition. As an alternative to inpatient care, the hospital transports patients home, where a doctor and nurse are waiting for them. They check the patients’ IVs and affix sensors to the patients’ body. They can tell whether patients sleep well or are up in the middle of the night. And, they can tell when patients no longer need medical oversight.

    The Johns Hopkins Schools of Medicine and Public Health have also developed a hospital at home model for qualified patients with particular conditions to check into their own bed for their hospital care. In this hospital at home model,  patients with certain types of pneumonia, congestive heart failure, chronic obstructive pulmonary disease and cellulitis, who would otherwise have to be hospitalized for treatment may never go to the emergency room. Doctors and nurses provide both diagnostic tests and treatment therapies to patients at home. It is intended to address the risks of treating acutely ill older adults in hospital, where they all too often experience adverse events, such as hospital-acquired infections, as a result of compromised immune systems.

    People in Australia, England and Canada have been benefiting from hospital at home programs for quite some time. But, in the US, insurers apparently have not come up with a model to pay for the services or a new definition of what it means for a patient to be “hospitalized.” 

    One small study found far lower costs for patients who participate in a hospital at home program than patients who are admitted to hospital, with no negative outcomes and similar patient satisfaction. Another study found that hospital readmission rates for hospital at home patients were about half as high as for hospital inpatients. Hospital at home care also makes it easier for family caregivers, who do not need to travel to the hospital to be with the people they love. But, insurers appear to be unwilling to innovate on this front. Right now, the hospital at home program is supported by foundation grants and the federal government.

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  • Pay attention when someone you love leaves the hospital

    Pay attention when someone you love leaves the hospital

    It’s not something most of us would instinctively believe, but hospitals can be dangerous places and leaving the hospital can be equally or more dangerous. According to the U.S. Agency for Health Care Research and Quality, AHRQ, almost one out of five patients who leave the hospital end up experiencing some harmful effect within 21 days. Yet, most of these events are preventable.  So, pay attention when someone you love leaves the hospital.

    Here’s Just Care’s checklist of seven things to do before you or someone you love leaves the hospital.

    What are the worst things that can happen to a patient upon hospital discharge? The AHRQ’s Patient Safety Network reports that the most serious complication comes from a bad reaction to a new prescription or medical regimen.  But, people also often pick up infections from antibiotic resistant bacteria in the hospital. And, some suffer procedural complications. Still others leave the hospital without lab results or with a need for follow-up tests, but do not follow through in a timely way or as warranted.

    The risks upon hospital discharge in part stem from a lack of care coordination between the in-hospital doctors and the patients’ primary care doctors and specialists. In addition, there are usually an overwhelming array of directives on discharge from the hospital. Without a “health care buddy,” someone whom you trust at your side as an extra pair of eyes and ears, who can ask questions on your behalf and make sure everything is in order for a safe transfer out of the hospital, there is a high likelihood of mixup.

    Keep in mind that it also can be extremely hard for a health care buddy or family member who is not a professional to appreciate the patients’ full range of care needs and how well patients can care for themselves once out of the hospital. Not surprisingly, one in five Medicare patients are rehospitalized in the 30 days after they are discharged.

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  • Could your hospital make you sick? How to protect yourself against hospital-acquired infections

    Could your hospital make you sick? How to protect yourself against hospital-acquired infections

    The hospital is a place that’s supposed to make us well. However, it can also make us very sick. Individuals who go to the hospital too often end up with severe—and sometimes fatal—infections simply from being there. For aging Americans, the risk is even higher.

    Hospital-acquired infections are a major concern for patients, their families, health care administrators—and all personnel who are associated with patient care. Here are some practical tips to better protect both you and your family against hospital-acquired infections.

    Officially known as healthcare-associated infections (HAIs), hospital-acquired infections fall into a broader category of infections that patients get while receiving treatment in a health care setting. They can be associated with procedures (like surgery), or devices that are used for treatment—such as invasive catheters.

    The overuse of antibiotics greatly contributes to both the existence of HAIs, as well as the inability to treat them effectively. Indeed, the effectiveness of many antibiotics is at serious risk because of their overuse and the consequent emergence of antibiotic-resistant bacteria.

    If you receive care in health care settings other than hospitals, you also can get these infections. These include places like outpatient surgery centers, dialysis centers, physician offices, and long-term care facilities.

    Two of the most common infections are Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile). C. difficile caused almost half a million infections among patients in the U.S. in just one year. More than 80 percent of the deaths associated with C. difficile occurred in patients 65 years or older, and many were in nursing homes. Aging Americans are more vulnerable to HAIs because they often have multiple medical conditions and their systems are more fragile and less able to fight off disease.

    The problem has become so serious that the White House has developed a strategy to combat antibiotic-resistant bacteria and the U.S. Department of Health and Human Services has developed a national action plan to prevent health care-associated infections.

    The good news is that there are a number of steps you can take in the hospital or other health care setting to help protect yourself and your family from getting one of these—or other—infections:

    • If possible, choose your hospital carefully; Consumer Reports offers hospital safety ratings on its web site by state at not charge. Medicare also has a web site comparing hospitals that provides information on healthcare-associated infections.
    • Ask health care workers to wash their hands before they touch you.
    • Ask if equipment has been properly sterilized before it’s used on you.
    • Ask questions about antibiotics, including what they are and if you really need them.
    • Know how to recognize an infection and ask about suspicious symptoms—such as diarrhea, fever, chills, and redness or drainage at a site.
    • Get vaccinated for common ailments that make your body susceptible to infection—according to your doctor’s guidance. (Medicare covers the flu shot, as well as the pneumonia vaccine, and the shingles vaccine.)
    • Consider having a health care buddy who can stay with you and advocate for you.
    • Stay away from health care settings, if at all possible. Talk to your doctor about whether receiving care at home may be a better option. 

    For more information on topics related to hospital and health care administration, check out the blog by MHA@GW, the online Master of Health Administration program offered by The Milken Institute School of Public Health at the George Washington University.

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