Less than half of Americans recognize antibiotic overuse as a problem

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Part of the growing problem of antibiotic resistance in the United States may be attributed to the fact that many Americans don't know what the drugs should be used for and what they can actually do.

Only 44 percent of surveyed Americans recognized as "somewhat or a big problem" that some diseases are becoming resistant to antibiotics, compared to 78 percent of survey takers recognizing the problems of obesity. While nine out of 10 Americans recognize that antibiotics can fight bacterial infections like strep throat, more than one third falsely think that they are also effective at fighting viral infections like the common cold. And, less than half -- 47 percent -- of Americans realize that their overuse of prescription antibiotics can harm others besides themselves.

"Not only is this a global issue from the perspective of nations having to deal with the issue and problem, but this is about getting the public to understand this is about their communities," Jay Campbell, vice president at Hart Research which was involved with the study, said during a conference call with reporters.

The Pew Charitable Trusts in conjunction with the Centers for Disease Control and Prevention (CDC) surveyed 1,004 adults about their understanding about the use of antibiotics as part of the CDC's "Get Smart About Antibiotics Week." In addition, they asked two focus groups -- one which had "frequent users" of antibiotics (meaning at least three times in the last two years) and the other a cross section of adults -- about their antibiotic-use beliefs and habits.

Antibiotic overuse has led to the growth of drug-resistant strains of bacteria. Each year 90,000 Americans die from health care-associated infections, many of which are drug-resistant, according to the Pew Health Group. And, the number is growing. From 1993 to 2005 the number of hospital stays involving Methicillin-resistant Staphylococcus aureus (MRSA) -- bacteria that causes severe infections such as bloodstream infections, surgical site infections, or pneumonia -- went up from 1,900 to 368,000 in the U.S. alone. Deaths due to Clostridium difficle -- bacteria commonly known as C. diff that causes several diarrhea and intestinal problems -- went up 35 percent each year from 1999 to 2004.

The majority of Americans -- 79 percent -- knew that taking antibiotics when they weren't necessary could make them less effective at treating their future illnesses, and 86 percent knew that they should take the full course of antibiotic prescriptions. Those statistics stayed similar no matter how educated the person was or how many antibiotics they had used in the past.

But, nearly all the people in the focus group admitted that even if their doctor told them to take all the antibiotics, they didn't complete the course and often stopped when symptoms disappeared.

In addition, 39 percent didn't realize that taking antibiotics unnecessarily can weaken the effect for the people around them, and 2 percent believed it could strengthen antibiotics' effects if more people took them when they did not have to. The focus group elaborated that they thought that antibiotic overuse led to personal "tolerance" to the drugs, not realizing it was also allowing drug-resistant bacteria to thrive and flourish.

Lauri Hicks, medical director of the CDC's "Get Smart: Know When Antibiotics Work" program, said on the conference call that the misconception that antibiotics can cure viruses and prevent people from getting sick is part of what's fueling antibiotic resistance. Too many parents are asking for antibiotics to cure to common cold, and doctors are too willing to prescribe the drugs even if they won't work. She estimates that more than half of prescriptions for antibiotics are ineffective.

"We're running out of treatment options for many infections and losing more lives to antibiotic resistances every day," she said.

Hicks suggested that talking to one's doctor or a child's doctor about an illness is always best, but antibiotics are not always the answer.

"Doctors should prescribe the right drug at the right dose at the right time," she said.

As for using antibacterial soaps and products, Hicks said the jury is still out whether or not they are increasing drug-resistance, although scientists are fairly certain that alcohol-based products are harmless. Still, nothing beats using good hand hygiene including basic hand washing.

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