According to the CDC, antibiotic use is the leading cause of antibiotic resistance. Up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate.
To combat antibiotic resistance and avoid adverse drug reactions, we must use antibiotics responsibly.
Listen as Kevin Sponsel, infectious disease pharmacist at Bryan Health, explains that you should try to use antibiotics only when necessary and use them responsibly.
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Use Your Antibiotics Responsibly
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Kevin Sponsel, infectious disease pharmacist
Kevin Sponsel is an infectious disease pharmacist at Bryan Health. Transcription:
Use Your Antibiotics Responsibly
Melanie Cole (Host): According to the CDC, antibiotic use is the leading cause of antibiotic resistance. Up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate. But, how do you use antibiotics responsibly? My guest today is Kevin Sponsel. He’s an infectious disease pharmacist at Bryan Health. Welcome to the show, Kevin. What does responsible use of antibiotics mean and why is this becoming even more important today?
Kevin Sponsel (Guest): Yes, Melanie. Thanks for asking. Thanks for having me. So, when we get sick with an infection, one of the first thoughts many of us have is, “I better go to the doctor and get some antibiotics.” It seems to make sense, after all, because we all know that antibiotics are used to treat an infection. Unfortunately, it’s not that simple. There are some extremely important things to consider with the use of these drugs. The first of which is that there are many different types of bugs that can cause an infection and the two most common types are bacteria and viruses. And, antibiotics actually don’t work on viruses, they only work on bacteria. Second, antibiotics can be lifesaving medications but they also have many unwanted effects. One of the most worrisome of these unwanted effects, something you touched on, is something called “resistance”. And this essentially means that bacteria can actually develop defenses against the antibiotics, making them ineffective. Some resistance develops with repeated exposure to antibiotics, and we need to use the right antibiotic every time, and to only use antibiotics when extremely necessary. So, development of resistance is happening much faster than new antibiotics can actually be discovered. So, it’s very important that we have responsible use of these antibiotics and it’s very essential to make sure we continue to use them and have them throughout time. This is such an important issue that Bryan Health has actually started an antibiotics stewardship program, where a team of healthcare providers helps make best decisions about antibiotic use.
Melanie: Is it possible also or, in your opinion, are we also using antibiotics in food or seeing it in milk and things, is that contributing to this resistance?
Kevin Sponsel: I think it is. There’s actually quite a bit of literature and people studying this. Most of our antibiotics use in the States and actually worldwide is actually in agriculture, so they give it to cattle, chickens, all sorts of animals, to help increase their weight, and the idea is that they’re decreasing infections. But, it’s really never been shown that those are effective uses of antibiotics. But, yes, antibiotic use in that setting does contribute to resistance. And, we all are part of that whole supply chain and food chain, and so we do come in contact, especially in the agriculture areas of America, with these antibiotic resistant bacteria that may have come from your cows.
Melanie: You used the term “antibiotic stewardship”. So, what is that? What does that mean for us?
Kevin Sponsel: Antibiotic stewardship is literally being good stewards of our antibiotic resources. It means taking care to use them correctly and responsibly to treat patients’ infections and to reduce side-effects and the development of resistance. So, our antibiotics stewardship team here at Bryan, includes a physician who specializes in infectious disease; myself, the infectious disease pharmacist; as well as many specialists in infection control in the microbiology lab; and many other healthcare providers. So, each of us looks at your infection from a slightly different point of view and then we use our combined expertise to help your doctor follow the “Five Rights”. And this is the right drug for the right bug at the right dose for the right amount of time for the right patients. And, basically, we work very, very hard to preserve the effectiveness of antibiotics so that we will always have these drugs to treat an infection.
Melanie: So, Kevin, people think that if they have green mucous, right away it’s a bacteria, and they need an antibiotic or if kids have an ear infection that’s been a source of some controversy whether you watch and wait or whether you do antibiotics right away. How do you know if you need an antibiotic for real?
Kevin Sponsel: Well, most upper respiratory infections like you’re describing, like ear infections or sinus infections or even a cough or bronchitis, are actually caused by viruses. And so, we know that antibiotics don’t work against viruses. You really can’t tell based on the color of the mucous or your nasal discharge whether or not it’s a virus or a bacteria. So, in that setting, we start looking for signs that are more emblematic of an actual bacterial infection. So, if you have a very high fever; localizing signs of pain like abdominal pain or shortness of breath; if you feel lightheaded or dizzy or if your cough or sore throat or these symptoms last longer than 10 to 14 days, those are all signs and symptoms of possibly a bacterial infection.
Melanie: What about the actual responsible use of antibiotics? What do you tell people as an infectious disease pharmacist about when they do actually have to take antibiotics? What are some of the most important things?
Kevin Sponsel: Well, I always ask them first, what are the symptoms they’re experiencing, and I’m very upfront and I tell them, “This maybe a bacterial infection or maybe a viral infection but your doctor’s going to run some tests; they’re going to use their experience in dealing with these types of infections; and then they’re going to get your medical history or talk about what you’ve been feeling, what some of your other diseases that you might have are; and they’re going to put that all into a big picture and come up with an idea of whether or not they think this needs antibiotics.” And then I say, “My job is to help you help your doctor pick the right antibiotic for you for the most likely bacteria that we think is causing your infection. And, on top of all that, we want to pick the right antibiotic that causes you the least amount of side effects or harm, and gives you the least chance of developing a drug-resistant bacteria.”
Melanie: And, if your healthcare professional does prescribe an antibiotic, what do you want them to know about taking it?
Kevin Sponsel: That it’s very important to take it as prescribed, and to complete the course of therapy that they give you. We come up with a very particular antibiotic and we want to treat for a very particular duration of therapy, and that’s to make sure that we get rid of the infection. We do lots of studies, and we have lots of experience with how long we should treat somebody for these infections, and so even if someone starts to feel better, we like to continue the course of therapy for the defined duration so we know that we feel confident that we’ve killed that bacteria.
Melanie: So, it’s very important for people to take the entire dose because some people say, “Well, I’m feeling better so I’m going to wait now and save these for the next time.”
Kevin Sponsel: Correct. It’s a very bad idea to save any medication for the next time because first, it loses its potency over time so you may, in fact, be giving yourself half the dose of antibiotic that you thought you were taking, the next time you get sick. There’s many different types of bacteria that can cause many different types of infection, and it’s not always the same one that causes that same infection. So, for instance, if you had a urinary tract infection, that bacteria could be different the next time you get an infection, and the antibiotic prescribed is tailored towards that first bacteria causing the infection so it may not even work, and you may just be exposing yourself to all the risks and harms associated with antibiotic use.
Melanie: And, what can people do if they’re interested in learning more about antibiotics stewardship?
Kevin Sponsel: For more information on antibiotics and whether they are needed or not, listeners can go to the Choosing Wisely campaign that’s available at www.choosingwisely.org. And then, you can search for patient resources, then antibiotics. And, also, the Center for Disease Control and Prevention has a very good website for patients--their Get Smart campaign. And, you can find that at www.cdc.gov or just searching for Get Smart in CDC.
Melanie: And, what are some of the most important things you want people to know about antibiotics? Wrap it up for us, Kevin.
Kevin Sponsel: Sure. I really want people to know that antibiotics are incredibly important drugs, and they can save lives when needed but if we keep overusing them, and misusing them, bacteria will continue to become resistant, and there’s a very real possibility that when you or your children need an antibiotic down the road, those antibiotics won't be able to treat the infections any more. And, that’s why it’s extremely important to only take antibiotics when they’re really needed for a bacterial infection, and to ask your healthcare provider if they work with an antibiotics stewardship team. That’s a very important question to ask because not all hospitals and not all clinics have access to an antibiotics stewardship team. It’s our job on that team as the infectious disease experts to help make sure that every patient gets the “Five Rights”--the right drug for the right bug at the right dose for the right amount of time for the right patient.
Melanie: Thank you so much, Kevin, for being with us today. It’s really great information and so important for people to hear. And, you can talk to your doctor if you have questions about antibiotics. If you do not have a doctor, you can go to bryanhealth.org/doctors. That’s bryanhealth.org/doctors. You’re listening to Bryan Health Radio. For more information, you can go to bryanhealth.org. This is Melanie Cole. Thanks so much for listening.
Use Your Antibiotics Responsibly
Melanie Cole (Host): According to the CDC, antibiotic use is the leading cause of antibiotic resistance. Up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate. But, how do you use antibiotics responsibly? My guest today is Kevin Sponsel. He’s an infectious disease pharmacist at Bryan Health. Welcome to the show, Kevin. What does responsible use of antibiotics mean and why is this becoming even more important today?
Kevin Sponsel (Guest): Yes, Melanie. Thanks for asking. Thanks for having me. So, when we get sick with an infection, one of the first thoughts many of us have is, “I better go to the doctor and get some antibiotics.” It seems to make sense, after all, because we all know that antibiotics are used to treat an infection. Unfortunately, it’s not that simple. There are some extremely important things to consider with the use of these drugs. The first of which is that there are many different types of bugs that can cause an infection and the two most common types are bacteria and viruses. And, antibiotics actually don’t work on viruses, they only work on bacteria. Second, antibiotics can be lifesaving medications but they also have many unwanted effects. One of the most worrisome of these unwanted effects, something you touched on, is something called “resistance”. And this essentially means that bacteria can actually develop defenses against the antibiotics, making them ineffective. Some resistance develops with repeated exposure to antibiotics, and we need to use the right antibiotic every time, and to only use antibiotics when extremely necessary. So, development of resistance is happening much faster than new antibiotics can actually be discovered. So, it’s very important that we have responsible use of these antibiotics and it’s very essential to make sure we continue to use them and have them throughout time. This is such an important issue that Bryan Health has actually started an antibiotics stewardship program, where a team of healthcare providers helps make best decisions about antibiotic use.
Melanie: Is it possible also or, in your opinion, are we also using antibiotics in food or seeing it in milk and things, is that contributing to this resistance?
Kevin Sponsel: I think it is. There’s actually quite a bit of literature and people studying this. Most of our antibiotics use in the States and actually worldwide is actually in agriculture, so they give it to cattle, chickens, all sorts of animals, to help increase their weight, and the idea is that they’re decreasing infections. But, it’s really never been shown that those are effective uses of antibiotics. But, yes, antibiotic use in that setting does contribute to resistance. And, we all are part of that whole supply chain and food chain, and so we do come in contact, especially in the agriculture areas of America, with these antibiotic resistant bacteria that may have come from your cows.
Melanie: You used the term “antibiotic stewardship”. So, what is that? What does that mean for us?
Kevin Sponsel: Antibiotic stewardship is literally being good stewards of our antibiotic resources. It means taking care to use them correctly and responsibly to treat patients’ infections and to reduce side-effects and the development of resistance. So, our antibiotics stewardship team here at Bryan, includes a physician who specializes in infectious disease; myself, the infectious disease pharmacist; as well as many specialists in infection control in the microbiology lab; and many other healthcare providers. So, each of us looks at your infection from a slightly different point of view and then we use our combined expertise to help your doctor follow the “Five Rights”. And this is the right drug for the right bug at the right dose for the right amount of time for the right patients. And, basically, we work very, very hard to preserve the effectiveness of antibiotics so that we will always have these drugs to treat an infection.
Melanie: So, Kevin, people think that if they have green mucous, right away it’s a bacteria, and they need an antibiotic or if kids have an ear infection that’s been a source of some controversy whether you watch and wait or whether you do antibiotics right away. How do you know if you need an antibiotic for real?
Kevin Sponsel: Well, most upper respiratory infections like you’re describing, like ear infections or sinus infections or even a cough or bronchitis, are actually caused by viruses. And so, we know that antibiotics don’t work against viruses. You really can’t tell based on the color of the mucous or your nasal discharge whether or not it’s a virus or a bacteria. So, in that setting, we start looking for signs that are more emblematic of an actual bacterial infection. So, if you have a very high fever; localizing signs of pain like abdominal pain or shortness of breath; if you feel lightheaded or dizzy or if your cough or sore throat or these symptoms last longer than 10 to 14 days, those are all signs and symptoms of possibly a bacterial infection.
Melanie: What about the actual responsible use of antibiotics? What do you tell people as an infectious disease pharmacist about when they do actually have to take antibiotics? What are some of the most important things?
Kevin Sponsel: Well, I always ask them first, what are the symptoms they’re experiencing, and I’m very upfront and I tell them, “This maybe a bacterial infection or maybe a viral infection but your doctor’s going to run some tests; they’re going to use their experience in dealing with these types of infections; and then they’re going to get your medical history or talk about what you’ve been feeling, what some of your other diseases that you might have are; and they’re going to put that all into a big picture and come up with an idea of whether or not they think this needs antibiotics.” And then I say, “My job is to help you help your doctor pick the right antibiotic for you for the most likely bacteria that we think is causing your infection. And, on top of all that, we want to pick the right antibiotic that causes you the least amount of side effects or harm, and gives you the least chance of developing a drug-resistant bacteria.”
Melanie: And, if your healthcare professional does prescribe an antibiotic, what do you want them to know about taking it?
Kevin Sponsel: That it’s very important to take it as prescribed, and to complete the course of therapy that they give you. We come up with a very particular antibiotic and we want to treat for a very particular duration of therapy, and that’s to make sure that we get rid of the infection. We do lots of studies, and we have lots of experience with how long we should treat somebody for these infections, and so even if someone starts to feel better, we like to continue the course of therapy for the defined duration so we know that we feel confident that we’ve killed that bacteria.
Melanie: So, it’s very important for people to take the entire dose because some people say, “Well, I’m feeling better so I’m going to wait now and save these for the next time.”
Kevin Sponsel: Correct. It’s a very bad idea to save any medication for the next time because first, it loses its potency over time so you may, in fact, be giving yourself half the dose of antibiotic that you thought you were taking, the next time you get sick. There’s many different types of bacteria that can cause many different types of infection, and it’s not always the same one that causes that same infection. So, for instance, if you had a urinary tract infection, that bacteria could be different the next time you get an infection, and the antibiotic prescribed is tailored towards that first bacteria causing the infection so it may not even work, and you may just be exposing yourself to all the risks and harms associated with antibiotic use.
Melanie: And, what can people do if they’re interested in learning more about antibiotics stewardship?
Kevin Sponsel: For more information on antibiotics and whether they are needed or not, listeners can go to the Choosing Wisely campaign that’s available at www.choosingwisely.org. And then, you can search for patient resources, then antibiotics. And, also, the Center for Disease Control and Prevention has a very good website for patients--their Get Smart campaign. And, you can find that at www.cdc.gov or just searching for Get Smart in CDC.
Melanie: And, what are some of the most important things you want people to know about antibiotics? Wrap it up for us, Kevin.
Kevin Sponsel: Sure. I really want people to know that antibiotics are incredibly important drugs, and they can save lives when needed but if we keep overusing them, and misusing them, bacteria will continue to become resistant, and there’s a very real possibility that when you or your children need an antibiotic down the road, those antibiotics won't be able to treat the infections any more. And, that’s why it’s extremely important to only take antibiotics when they’re really needed for a bacterial infection, and to ask your healthcare provider if they work with an antibiotics stewardship team. That’s a very important question to ask because not all hospitals and not all clinics have access to an antibiotics stewardship team. It’s our job on that team as the infectious disease experts to help make sure that every patient gets the “Five Rights”--the right drug for the right bug at the right dose for the right amount of time for the right patient.
Melanie: Thank you so much, Kevin, for being with us today. It’s really great information and so important for people to hear. And, you can talk to your doctor if you have questions about antibiotics. If you do not have a doctor, you can go to bryanhealth.org/doctors. That’s bryanhealth.org/doctors. You’re listening to Bryan Health Radio. For more information, you can go to bryanhealth.org. This is Melanie Cole. Thanks so much for listening.