Oregon among lowest in unneeded antibiotics use
But experts say misuse leading to dangerous resistance
Antibiotics are prescribed less often in Oregon than in other states, but their unnecessary use continues, and that can lead to more cases of potentially deadly drug resistance, state public health officials said Monday.
The Oregon Health Authority's Alliance Working for Antibiotic Resistance Education (AWARE) program has observed less resistance in bacteria most responsible for serious respiratory infections, such as pneumococcus, thanks to Oregon's low antibiotic prescribing rates, said Dr. Ann Thomas, a public health physician in OHA's Public Health Division and AWARE's medical director.
But figures from Oregon's medical and pharmacy claims database show that broad-spectrum antibiotics -- drugs that can be used to treat a wide variety of different bacterial infections -- were used on 55 percent of upper respiratory infections in 2011, and were used in a majority of cases of bronchitis and the common cold, which rarely require treatment.
As part of its ongoing effort to urge consumers to help reduce inappropriate use of antibiotics, AWARE, funded by the U.S. Centers for Disease Control and Prevention, is taking part in "Get Smart About Antibiotics Week" Nov. 18-24.
AWARE is partnering with the Oregon State University College of Pharmacy to offer educational information and activities promoting appropriate antibiotic use and hand hygiene during a free public event called "AWARE on the Square," set for 8 a.m. to 5 p.m. Friday, Nov. 22, at Portland's Pioneer Courthouse Square. They also are providing free flu vaccinations for uninsured adults from 7 a.m. to 4 p.m.
Colds and the flu are caused by viruses, and antibiotics are ineffective for treating viruses. Taking antibiotics when they're not needed or not as prescribed increases a person's risk for later antibiotic-resistant infections. These infections are more difficult to treat and require much stronger antibiotics that may cause serious side effects.
"Antibiotics should only be used when necessary, and for bronchitis and the cold, they're simply not necessary," Thomas said. "In fact, using antibiotics to treat these common ailments is potentially dangerous."
AWARE, reviewing the state claims database, found that 90 percent of patients treated for bronchitis receive a broad-spectrum drug, and 66 percent of patients receiving antibiotics for the common cold receive broad spectrum antibiotics.
The likelihood a person would be inappropriately prescribed these types of antibiotics increases with age: Only 34 percent of children 5 and younger in Oregon received broad spectrum antibiotics for upper respiratory tract infections, compared to 40 percent of kids ages 5 to 17 and 72 percent of persons aged 18 to 64.
Thomas credited health care providers for working hard to reduce excessive antibiotic prescriptions, which has helped to keep antibiotic resistance relatively low in Oregon - only 5 percent of serious pneumococcal infections in the Portland area were resistant to penicillin in 2011, she says. But bacteria resistant to commonly used drugs are increasingly becoming known.
Thomas recommended health care providers take time to educate their patients about antibiotic resistance and the possibility of serious side effects, including allergic reactions that result in a rash and anaphylaxis, and send thousands of patients to the emergency room every year.
She also says consumers shouldn't pressure their providers to prescribe antibiotics for colds and the flu. Consumers appropriately prescribed antibiotics for bacterial infections, however, should take every dose, even if symptoms improve, since not doing so contributes to drug resistance.
And consumers should never share antibiotics, since individuals taking antibiotics not prescribed to them can experience adverse reactions.
To learn more about Oregon AWARE and Get Smart About Antibiotics Week, call 971-673-1111 or visit www.healthoregon.org/antibiotics. For information about the CDC's national "Get Smart" campaign, visit www.cdc.gov/getsmart/.
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