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Overuse of Antibiotics a Boon for 'Supergerms'

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"Superbugs" are not just for science fiction anymore. In American communities, large and small, antibiotic-resistant bacteria are ravaging hospitals and killing thousands of patients every year. These "supergerms" are gradually replacing the typical antibiotic-sensitive bacteria in the hospital, making it more likely that this problem will become increasingly prevalent.

Sadly, the American health care system is largely responsible for this looming epidemic. Between physicians and pharmaceutical companies, new antibiotics are constantly incorporated into patient therapy. Because these more powerful and potent medications can attack a wider array of bacteria, there is a widespread destruction of sensitive organisms. But looming in the background are "superbugs," which are resistant to the onslaught of new therapy. These tiny germs multiply in huge numbers, filling the void left by eradication of traditional hospital-based bacteria, and they ultimately become ever more sophisticated and difficult to kill.

The problem with the overuse of newer, more sophisticated antibiotics is not limited to treatment of hospitalized patients; rather it starts in the primary-care clinic with the treatment of minor bacterial or viral illnesses. Many physicians prescribe antibiotics for viral infections, and most frequently, they prefer the newest, most expensive therapy. These days, physicians prescribe Levaquin or Zithromycin (Z Pack) for a simple viral infection, bacterial sinusitis or bronchitis. Not only are these drugs less effective in the treatment of minor bacterial infections, but also their use leads to the greater prevalence of resistant bacteria that can lead to life-threatening infections.

A similar situation applies to the treatment of urinary tract infections, where the tried and true medications should be used before the newer and more powerful antibiotics. In general, newer therapies should be kept in reserve for the less frequent infections that have become resistant to the older drugs.

Even worse than inappropriate care by physicians, patients are often responsible for the overuse of antibiotics. During the winter months, not a day goes by without a patient requesting an antibiotic for a cough, runny nose or sore throat. Physicians who try to convince their patients that antibiotics are not needed are almost always met with a great deal of skepticism.

In many cases, skepticism turns to outright aggression and a lengthy argument follows.

It's easy to see why most physicians take the path of least resistance and give in to their patients' request — it is just not worth the trouble. And if something untoward happens (always a possibility in the uncertain world of medicine and illness), there is the threat of litigation.

If you become sick, try to determine if your illness is the result of a virus or bacteria. Only when a proven bacterial infection exists should an antibiotic be prescribed. Viruses are the most common causes of upper respiratory infections. Bacterial (usually strep) infections of the throat are quite rare — more common in children — and present with a high fever, severe sore throat, white spots at the back of the throat and enlarged painful nodes in the neck. Antibiotics should never be used for someone who has a runny nose or cough without a significant fever.

A secondary bacterial infection should be suspected if the runny nose persists for a prolonged period of time and mucus drainage becomes thick and yellow green in color. Bronchitis is frequently viral, but in the case of a bacterial infection, the cough produces thick yellow or green sputum that is often blood tinged. This is usually accompanied by a temperature greater than 101 degrees. In viral infections, the temperature is lower and the cough produces only small amounts of clear sputum.

Curbing the overuse of antibiotics is the first step in addressing the epidemic of "supergerms" in our hospitals and communities. But should you find yourself in a hospital for a prolonged period of time, risk of exposure to dangerous bacteria is high. Most life-threatening bacterial infections are acquired inside the hospital. Try to shorten your stay whenever possible.

We must all do our part to end the onslaught of antibiotic resistant bacteria. Physicians must reserve the most powerful antibiotics for when they are truly needed. And patients must better understand the dangers of prescribing antibiotics without just cause. In the case of the "superbug," the key to prevention is in moderation. We must save our newer, more potent therapies lest they, too, become obsolete.

Dr. David Lipschitz is the author of the books, "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.

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