JustCare

Tag: Antibiotics

  • 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.

    Here’s more from Just Care:

  • 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.

    Here’s more from Just Care:

  • Coronavirus: Federal government should reconsider drug research incentives to prioritize public health

    Coronavirus: Federal government should reconsider drug research incentives to prioritize public health

    A new report from Public Citizen lays out the reasons for concern about the new coronavirus and the likelihood of future pandemics. In short, the US does not have a good system in place to develop treatments or vaccinations for these viruses. To address this problem, Public Citizen makes the case for changing the way our government incentivizes research and development so that the public health becomes the chief priority and not corporate profits.

    Over the last 20 years, we have now seen three different instances of coronavirus spreading around the world and causing grave harm to people. We had SARS in 2002, severe acute respiratory syndrome. We had MERS in 2012, Middle East respiratory syndrome. And, we have the novel coronavirus now.

    Government-funded research to develop tests, treatments and vaccines that protect against coronavirus disease is critical. And, the National Institutes of Health has been funding that research since 2002. All in, the NIH has invested more than $684 million in this research.

    But, we still depend on big Pharma for treatments and vaccines to protect against coronavirus disease, even though pharmaceutical companies have not been investing in this research to any significant degree, participating in just six clinical trials. We must stop relying on these for-profit companies to provide us with the treatments we need for novel viruses and infections. Even when they have treatments, we cannot count on pharmaceutical companies to provide them at an affordable price.

    Right now, to encourage pharmaceutical companies to undertake critical research, the US government gives them patent monopolies, allowing them effectively to set prices. The goal is to incentivize them to invest by promising that they will be able to secure a reasonable profit from a successful drug. But, instead, pharmaceutical companies with successful drugs use their monopoly power to drive drug prices sky-high and keep generics from entering the market. Moreover, they market their drugs heavily in cases where other less expensive drugs will provide better treatment.

    Our patent system induces pharmaceutical companies to develop drugs that can earn them the greatest profit–such as cancer drugs–rather than drugs that treat the greatest needs. Cancer drugs now have an annual average price of $149,000. It hardly matters to a pharmaceutical company that its new cancer drug does not deliver a better benefit to patients than other drugs already developed.

    Pharmaceutical companies can make killer profits if they focus on developing drugs to treat chronic conditions, often regardless of their safety or efficacy. A Government Accountability Report shows that the 25 biggest pharmaceutical companies brought in on average twice the profits as the biggest 500 companies!

    Vaccines and antibiotics, in stark contrast, are far less profitable than cancer drugs and drugs for other chronic conditions. One-time cures deliver less revenue than medicines that are taken in perpetuity. Put differently, developing drugs to treat infectious diseases is not a good business model. Consequently, pharmaceutical companies have few in the pipeline.

    In short, we cannot count on the pharmaceutical industry for treatments for infectious diseases and drug-resistant bacteria. So, what is to be done? Without new antibiotics, a U.K. report found that antibiotic-resistant bacteria could kill 10 million people a year by 2050.

    We must stop giving pharmaceutical companies monopoly pricing power on their drugs. The lack of available treatments for the novel coronavirus demonstrates that our research model is broken and that we need a new model. Perhaps the government should be manufacturing drugs as well as paying for research and development. Or, it should be giving licenses to whichever companies want to manufacture a needed drug in order to drive competition.

    We might also consider separating research costs from the prices charged for drugs in order to ensure everyone can benefit from needed drugs—an idea that enjoys support from some on the ideological right and the left.

  • Skip the urine test, unless you have symptoms

    Skip the urine test, unless you have symptoms

    Step into a doctor’s office for a checkup and more often than not, you’ll be weighed, your blood pressure will be checked and you will be asked to pee in a cup so that your urine can be tested. For older adults, a urine test is generally of little if any benefit and can be harmful, writes Paula Span for The New York Times. Unless you have symptoms, ask your doctor if you can skip it.

    What’s particularly odd about urine testing is that it’s done on people who have no symptoms of infection—no pain or blood when they urinate, no fever. If the lab finds bacteria in the urine, as is typical for older adults—positive lab results—it is not a sign of infection or a need for treatment. Still, older adults with bacteria in their urine, without symptoms, are often prescribed antibiotics.

    Indeed, the older you are, the more likely it is for doctors to prescribe you antibiotics even though you don’t need them, according to findings in one study. JAMA Internal Medicine recently published an editorial about this problem. The latest recommendation is for doctors to stop giving urine tests to older adults who are asymptomatic for infection.

    The US Preventive Services Task Force, an independent expert group, has asserted repeatedly since 1996 that no one without symptoms benefits from a urine test, except pregnant women. And, particularly for older adults, there are risks of harm from antibiotics, which they may be prescribed but don’t need. Side effects include nausea, harm to kidneys and harmful drug interactions, as well as C-difficile, which can be extremely difficult to treat.

    It had been thought that urinary tract infections could cause delirium in older adults, but today many people think that view is baseless. It’s more likely that patients with delirium are dehydrated and need liquid or experienced a disorienting change of medicines or place.

    Doctors need to stop prescribing antibiotics when they are not necessary. And patients need to ask more questions when tests are recommended. Do I really need this test? Why? If it’s simply routine, ask to skip it. If a urine test is intended to determine the cause of symptoms, such as pain when you’re peeing, you need it. Here are more questions to ask to avoid overtreatment.

    Here’s more from Just Care:

  • Do you really need that antibiotic?

    Do you really need that antibiotic?

    According to a new study in BMJ, nearly one-quarter of antibiotic prescriptions filled by those with private insurance were not medically justified, leading to concerns about antibiotic overuse, antibiotic resistance and adverse events, the last particularly in children.

    Researchers looked at insurance recording for 19 million children and adults (ages 18 to 64) for 2016. About 7.6 million of those – about 40% — filled at least one antibiotic prescription. However, in 23% of those cases, the medications were not medically justified. About 36% were determined to be potentially appropriate and 28% did not have a diagnosis associated with it.

    Researchers found that antibiotics are most often overprescribed for bronchitis and the common cold, conditions caused by viruses and which antibiotics are ineffective against.

    “Despite decades of quality improvement and educational initiatives, providers are still writing antibiotic prescriptions for illnesses that would get better on their own,” lead author Kao-Ping Chua, MD, PhD, a researcher and pediatrician at University of Michigan C.S. Mott Children’s Hospital and the UM Institute for Healthcare Policy and Innovation, said in a statement. “Antibiotic resistance is one of the greatest threats to public health in the world, and the large number of antibiotics that providers prescribe to patients is a major driver of resistance.”

    A study conducted by the Centers for Disease Control and Prevention (CDC) last year found that antibiotics are the leading cause for emergency room visits due to drug adverse events in children.

    Chua also cited CDC statistics that every year in the US, 2 million people suffer from antibiotic-resistant infections and 23,000 die.

    The study found that the rate of antibiotic prescriptions is 805 per 1,000 people. National data indicate that around 270 million antibiotic prescriptions are filled every year.

    This article originally appeared in Medshadow.org

    Here’s more from Just Care:

  • Finish your antibiotics!

    Finish your antibiotics!

    There are two simple ways to get the most out of your antibiotics and avoid promoting antibiotic resistance.
    • First, if your doctor prescribes an antibiotic, please take the entire course (even if you are feeling better). Finish your antibiotics! When you don’t take the whole course or skip doses, there could still be surviving target bacteria. Surviving target bacteria can develop a resistance to the antibiotic and spread that resistance to other bacteria.  If you need to take that antibiotic drug again, it might not be effective, and you will be left with fewer options to fight your infection.
    • Second, you should only take an antibiotic if you know for sure that you have a bacterial infection that it will cure. Ask your doctor before assuming you need an antibiotic.  If you take an antibiotic when you don’t have a bacterial infection, it will only kill the good bacteria in your body, which are part of your natural immunity. Killing your good bacteria can lead to other infections in your body, like a GI problem or yeast infections in women.

    Antibiotics have potential drug interactions. So, please be sure to take the correct ones and know which medications you shouldn’t be taking with them. Keep a list of all your medications in your wallet to share with your doctor. Taking the wrong antibiotics will only promote resistance in bacterial communities. Antibiotics continue to be lifesaving. Let’s keep them that way by not promoting antibiotic resistance.

    Originally published January 15, 2015

    Here’s more from Just Care:

  • 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.

    _______________________

    Here’s more from Just Care:

  • Effectiveness of antibiotics at serious risk thanks to overuse in animals

    Effectiveness of antibiotics at serious risk thanks to overuse in animals

    Antibiotics are becoming increasingly ineffective at treating people, and doctors are seeing a significant number of their patients die as a consequence, according to a new report from Consumers Union and U.S. PIRG.

    In a survey of 500 doctors, 425 reported that one or more of their patients had been presumed or diagnosed infected with a multi-drug resistant bacterial infection in the last year.  They said that more than one in three of these patients had either died or suffered serious health complications.

    According to the CDC, about 23,000 Americans die each year from antibiotic-resistant bacteria.  The high frequency of antibiotic use in food-producing healthy animals is a large part of the cause. About 80 percent of the antibiotics used in the United States are for livestock to promote growth.  Only about 20 percent are used on people.