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Hospitals' Use of Antibiotics Rise, Despite Concerns

Nov 11, 2008 | Parker Waichman LLP

Although many experts are seriously concerned about the rise in bacterial resistant infections,  antibiotic use at U.S. hospitals continues to mount.  Researchers blame Wyeth's Zosyn and the older drug vancomycin for leading the movement in such antibiotic overuse.

Yesterday, Ronald Polk of Virginia Commonwealth University (VCU) and colleagues reported in the journal Archives of Internal Medicine that antibiotic use at a group of U.S. academic medical centers rose seven percent in the years from 2002 to 2006.  "We know from past experience that when we start using any antimicrobial drug excessively, that resistance to that drug eventually appears," Polk said.  "Given the fact that there are very few new antimicrobial drugs being discovered, the message is that we really need to learn how to use the available drugs better."

The researchers tracked data on anti-bacterial drugs at 22 hospitals nationwide over the full five years and, in 2006, based on the data from 35 such university teaching hospitals, they found that 64 percent of all patients received one antibiotic dose.  This rise in antibiotic abuse is alarming experts who note that drugs that once killed the germs no longer do so.  This means an illness may last longer and be more likely to be fatal.  Another downfall is that health care costs increase when infections are not cured with established antibiotic treatments.  Worse, resistance to drugs can render those medications useless.

The researchers noted that both Wyeth's Zosyn—generically known as piperacillin-tazobactam—rose 84 percent from 2002 to 2006 at the hospitals studied.  Also, the use of vancomycin rose 43 percent in the same time frame at the hospitals studies, according to the research.  Both piperacillin-tazobactam and vancomycin were used to treat a wide array of bacterial infections.  The study indicated that other antibiotic use remained stable.

Also, while overuse of antibiotics continues to remain a major concern to many public health experts, documentation of antibiotic overuse at U.S. hospitals has been challenging to obtain and continuing to increase.  Polk said the findings likely reflect nationwide trends and said that hospitals should be more judicious in their use of antibiotics.  For instance, Polk suggests that antibiotics are only prescribed to patients when absolutely necessary.  Polk also suggests that hospitals adopt "stewardship programs" in order to ensure prudent use of antibiotic medications.  "It's easy to get into a mind-set of just using them for any trivial condition," Polk said. "We are undoubtedly overusing these drugs.  But having a positive impact on that trend of overuse is a tough thing to do."

Patients must understand that when it comes to antibiotics, less is often better, Polk said, calling the problem cyclical.  More bacterial resistance to one drug leads to use of other drugs, thus causing more resistance to those drugs.

And, now, antibiotic resistance is seen in staph— methicillin-resistant Staphylococcus aureus—antibiotic resistant E. coli, and antibiotic resistant C. diff, to name just a few.


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