Combating superbugs means giving doctors tools to ‘do the right thing’
Sep 23, 2016, 1:40 PM
The United Nations convened this week in New York to talk about the Syrian refugee crisis, globalization, terrorism, democracy and, surprisingly if you’re not in the medical community, the threat of the superbug.
Yes, a bacteria so threatening that the United Nations is trying to tackle it.
Related: More cases of superbug precursor reported, but no spread
A superbug is a strain of bacteria that shows antibiotic-resistance. MRSA is one superbug you might recognize. Medical professionals across the country are trying to warn that more superbugs are cropping up and they’re getting smarter and stronger.
The solution seems to be simple.
“We need to stop overusing antibiotics and I know it’s a temptation,” said Sylvia Mathews Burwell, secretary of Health and Human Services. “I’m the mother of a 6 and an 8-year-old and I know what it’s like when you go to the doctor, but making sure only when needed.”
Doctor John Lynch, Harborview’s Medical Director of Infection Prevention, says the issue is two-fold and it starts with a visit to the doctor’s office. Patients need to realize that not all illnesses need a pill.
“You know, we’re just used to this and this is common throughout the world is that you go to a doctor and you expect something to either make you feel better right away or get you feeling better faster,” Lynch said. “And so we have this association between getting something when we go to the doctor versus what really needs to be told is ‘Hey, what you got here was an assessment to make sure that you don’t have a bacterial infection that can progress and hurt you. What you really have is a viral infection and it will clear up on its own.”
I recently watched a video out of Harvard where they took a large, rectangular petri dish and divided it like a football field. The outsides section had no antibiotics and then moving in sections toward the middle researchers applied an antibiotic 1, 10, 100 and then 1,000-times stronger. In the end, it took the bacteria just 11 days to mutate and infect the portion with the strongest power of antibiotic.
Based on what Lynch told me, that’s a great example of what happens in our bodies, which then impacts the people around us.
“When you use an antibiotic in one group of people, it has an impact on people who aren’t taking the drug,” Lynch said. “What I mean by that is we all are carrying good and bad bacteria. When you take an antibiotic, it has an impact on those bacteria living on your body And when you look at doing that in the order of hundreds, thousands or millions of times in a population, then those bacteria can basically become resistant and move around from one person to the next.”
The second part of the solution to over-prescribing antibiotics is doctors effectively communicating to patients that they might not need it right away. Maybe wait a couple of days and if the infection doesn’t improve, then they can discuss antibiotics. Additionally, doctor’s offices need better swab tests for superbugs, just like the ones we have for influenza.
“The most up-to-date influenza tests are a simple swab of the nose and the results are back within a couple of hours,” Lynch said. “So, if you know someone comes in with pneumonia in the hospital, and you get an influenza tests, and it’s positive within a couple of hours, you know you don’t need to treat them with anatomic.”
But right now, swabs for superbugs, like MRSA, are not widely available and very expensive.
The other solution, and this might seem counter-intuitive, is to develop more antibiotics with the caveat of using them conservatively.
“Pretty much who can prescribe anything can prescribe an antibiotic,” Lynch said. “And when you’re faced with a patient in front of you who’s not feeling well, the pressure is… you want to help that person. And we need to find a way to give those prescribers the tools to accurately diagnose those folks and doing the right thing. In some cases by not giving them an antibiotic.”
