According to the CDC, antibiotics have transformed the practice of medicine, making once lethal infections readily treatable and making other medical advances, like cancer chemotherapy and organ transplants, possible.
On this segment, Ellsworth Pryor III, MD., discusses improving the use of antibiotics as an important patient safety and public health issue.
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Antibiotic Stewardship and Infection Control
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Learn more about Ellsworth Pryor III, MD
Ellsworth Pryor III, MD
Ellsworth Pryor III, MD is an infectious disease specialist and a member of the medical staff at Henry Mayo Newhall Hospital.Learn more about Ellsworth Pryor III, MD
Transcription:
Antibiotic Stewardship and Infection Control
Melanie Cole (Host): According to the CDC, antibiotics have transformed the practice of medicine, making once lethal infections readily treatable and making other medical advances like cancer chemotherapy and organ transplants possible. My guest today is Dr. Ellsworth Pryor. He's an infectious disease specialist and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show, Dr. Pryor. Tell us what's going on with antibiotics in this country. Are we overusing them? Are we using them appropriately? What is antibiotic stewardship?
Dr. Ellsworth Pryor (Guest): Antibiotic stewardship is trying to promote the appropriate use of antibiotics, antimicrobials. The problem has been that we, in fact, are overusing or have overused antibiotics in the past. And, what we're trying to do is to establish guidelines for their use, so they're used at the right time for the right indication, for the right duration. And try to limit the exposure of these microorganisms that are becoming more and more resistant to the drugs that we have available. The problem is, is that there's not been a whole lot of development of new antibiotics. There hasn't been an original new antibiotic that has come on the market probably in more than 10 years, and we basically have more resistant bugs and fewer drugs that are effective. We're also trying to decrease the hospital-acquired inspection that occur in healthcare settings, in particularly in hospital, by increasing infection control measures such as hand washing and simple things like that. But also controlling the overuse and promote appropriate use of antibiotics in that setting.
Melanie: So for the consumer, Dr. Pryor, people sometimes I'm sure come to you, they've got the sniffles and they want an antibiotic. What do you want the consumer and your patients to know about when antibiotics are appropriate to use?
Dr. Pryor: That's an important piece to the puzzle, because people have come to expect that the doctor will give them an antibiotic for, you know, their complaint, their symptoms. Most of the sniffles and a cold, flu, are caused by viruses, and antibacterials will basically do nothing for that. And so, we’re trying to -- patient education is a very important piece of that. There are posters and fliers, the patient education material that can be obtained on the CDC website. A lot of education is there and it's not only for healthcare providers, but also for patients as well. So, you know, that also is a very important piece of all this.
Melanie: And people think that they should have antibiotics for certain things and not -- maybe they've got green sputum, so they assume that's a bacteria. What do you want them to know about what things they do need them for?
Dr. Pryor: Well, you know, it all depends. If it’s a patient that's older and has some underlying chronic lung disease, you know, such as COPD — Chronic Obstructive Pulmonary Disease — those patients may need a short course of antibiotics. But if it's a, you know, a 17-20 year old individual who's otherwise healthy, and they come in with the sniffles and maybe a little cough, more than likely it's not bacterial. It's most likely viral, and they don't need to be placed on antibiotic. And a lot of times patients don't understand that and they may be very demanding or impatient. It may be easier for the doctor in the past to just write a prescription rather than sit down and try to educate the individual, the patient, about what's really going on and what's the best for them.
Melanie: Do you feel that antibiotics in other settings are contributing to this resistance? Maybe antibiotics in our food or in our liquids — do you think that contributes to this as well?
Dr. Pryor: There's no question about that. There is extensive use of antimicrobials in that industry. They often are growth factors for animals that we use as part of our food supply. Yeah, absolutely, there's no question that that is one of the contributing factors to all this resistance that we're seeing develop in the bacteria.
Melanie: And for certain things like sepsis or C. difficile, obviously antibiotics are so important in that situation. Are you seeing that maybe they're not as effective as they might otherwise be for those maybe emergent situations, because of all this?
Dr. Pryor: Yes. We've definitely seen rises in Clostridium difficile infections, which can be very, very severe and very devastating to the patient. You know, that's part of the piece to the puzzle as to why people get C. difficile. We're seeing more C. difficile actually now in the community rather than hospital-acquired. In the community. And surely, in patients that are critically ill with sepsis, it's important to have drugs that are effective, and that's becoming difficult in some [00:06:45 – Inaudible].
Melanie: So then, wrap it up for us — for dose adjustment and optimization, for physicians and for the consumer, what you want them to know about appropriate antibiotic use, when it's to be used, and when maybe it shouldn't, and you watch and wait.
Dr. Pryor: Well, you know, again, it's the right drug at the right time, the right dose, and for the right indication, and there are published guidelines. There's more and more guidelines coming out from CDC, coming out from our medical professional society. And it's important not only for physicians to be educated on it, for the public as well. And the CDC is an excellent reference for that.
Melanie: Thank you so much for being with us today, Dr. Pryor. It's very important information for people to hear. You're listening to It's Your Health Radio with Henry Mayo Newhall Hospital. And for more information, you can go to henrymayo.com. That's henrymayo.com. This is Melanie Cole. Thanks so much for listening.
Antibiotic Stewardship and Infection Control
Melanie Cole (Host): According to the CDC, antibiotics have transformed the practice of medicine, making once lethal infections readily treatable and making other medical advances like cancer chemotherapy and organ transplants possible. My guest today is Dr. Ellsworth Pryor. He's an infectious disease specialist and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show, Dr. Pryor. Tell us what's going on with antibiotics in this country. Are we overusing them? Are we using them appropriately? What is antibiotic stewardship?
Dr. Ellsworth Pryor (Guest): Antibiotic stewardship is trying to promote the appropriate use of antibiotics, antimicrobials. The problem has been that we, in fact, are overusing or have overused antibiotics in the past. And, what we're trying to do is to establish guidelines for their use, so they're used at the right time for the right indication, for the right duration. And try to limit the exposure of these microorganisms that are becoming more and more resistant to the drugs that we have available. The problem is, is that there's not been a whole lot of development of new antibiotics. There hasn't been an original new antibiotic that has come on the market probably in more than 10 years, and we basically have more resistant bugs and fewer drugs that are effective. We're also trying to decrease the hospital-acquired inspection that occur in healthcare settings, in particularly in hospital, by increasing infection control measures such as hand washing and simple things like that. But also controlling the overuse and promote appropriate use of antibiotics in that setting.
Melanie: So for the consumer, Dr. Pryor, people sometimes I'm sure come to you, they've got the sniffles and they want an antibiotic. What do you want the consumer and your patients to know about when antibiotics are appropriate to use?
Dr. Pryor: That's an important piece to the puzzle, because people have come to expect that the doctor will give them an antibiotic for, you know, their complaint, their symptoms. Most of the sniffles and a cold, flu, are caused by viruses, and antibacterials will basically do nothing for that. And so, we’re trying to -- patient education is a very important piece of that. There are posters and fliers, the patient education material that can be obtained on the CDC website. A lot of education is there and it's not only for healthcare providers, but also for patients as well. So, you know, that also is a very important piece of all this.
Melanie: And people think that they should have antibiotics for certain things and not -- maybe they've got green sputum, so they assume that's a bacteria. What do you want them to know about what things they do need them for?
Dr. Pryor: Well, you know, it all depends. If it’s a patient that's older and has some underlying chronic lung disease, you know, such as COPD — Chronic Obstructive Pulmonary Disease — those patients may need a short course of antibiotics. But if it's a, you know, a 17-20 year old individual who's otherwise healthy, and they come in with the sniffles and maybe a little cough, more than likely it's not bacterial. It's most likely viral, and they don't need to be placed on antibiotic. And a lot of times patients don't understand that and they may be very demanding or impatient. It may be easier for the doctor in the past to just write a prescription rather than sit down and try to educate the individual, the patient, about what's really going on and what's the best for them.
Melanie: Do you feel that antibiotics in other settings are contributing to this resistance? Maybe antibiotics in our food or in our liquids — do you think that contributes to this as well?
Dr. Pryor: There's no question about that. There is extensive use of antimicrobials in that industry. They often are growth factors for animals that we use as part of our food supply. Yeah, absolutely, there's no question that that is one of the contributing factors to all this resistance that we're seeing develop in the bacteria.
Melanie: And for certain things like sepsis or C. difficile, obviously antibiotics are so important in that situation. Are you seeing that maybe they're not as effective as they might otherwise be for those maybe emergent situations, because of all this?
Dr. Pryor: Yes. We've definitely seen rises in Clostridium difficile infections, which can be very, very severe and very devastating to the patient. You know, that's part of the piece to the puzzle as to why people get C. difficile. We're seeing more C. difficile actually now in the community rather than hospital-acquired. In the community. And surely, in patients that are critically ill with sepsis, it's important to have drugs that are effective, and that's becoming difficult in some [00:06:45 – Inaudible].
Melanie: So then, wrap it up for us — for dose adjustment and optimization, for physicians and for the consumer, what you want them to know about appropriate antibiotic use, when it's to be used, and when maybe it shouldn't, and you watch and wait.
Dr. Pryor: Well, you know, again, it's the right drug at the right time, the right dose, and for the right indication, and there are published guidelines. There's more and more guidelines coming out from CDC, coming out from our medical professional society. And it's important not only for physicians to be educated on it, for the public as well. And the CDC is an excellent reference for that.
Melanie: Thank you so much for being with us today, Dr. Pryor. It's very important information for people to hear. You're listening to It's Your Health Radio with Henry Mayo Newhall Hospital. And for more information, you can go to henrymayo.com. That's henrymayo.com. This is Melanie Cole. Thanks so much for listening.