Primary care physicians, often regarded as the first line of healthcare defense, hold great sway in the fight against antimicrobial resistance (AMR) – a growing concern within global health circles. However, the responsibility to curb AMR isn’t theirs alone. All healthcare professionals, including clinicians, need to adopt concerted efforts, routed in consistency and perseverance.
A significant advocate for this collaborative approach is Priya Nori, MD, who serves as the Medical Director of Antimicrobial Stewardship at Montefiore Health System in the Bronx, New York. Dr. Nori emphasizes the role of both clinicians and patients in this cause, particularly focusing on antibiotic usage. The clamor among patients for antibiotics to treat illnesses with cold or flu-like symptoms, which are most likely viral, often leads to unnecessary and potentially harmful usage of these drugs.
Recognizing this reality, and with a newly fostered understanding of the difference between viruses and bacteria among patients due to the COVID-19 pandemic, Dr. Nori urges healthcare professionals to educate patients about the ineffective nature of antibiotics against viral infections. About 90% of the infections, especially during the colder months, are likely to be viral – against which antibiotics offer no help.
Diagnosing accurately is the first step, followed by counseling patients about the nature of their ailments and the appropriate therapeutic recourse. This could involve the provision of supportive care, such as prescribing decongestants, granting leave from work, and setting up a follow-up mechanism to monitor the patient’s progress. The possibility of prescribing antibiotics should only be considered if the patient’s condition worsens, indicating a potential bacterial infection.
Ensuring effective communication with patients about the importance of antimicrobial stewardship is crucial. While the concept of antibiotic resistance may appear abstract to many, it’s essential to discuss the potential direct impacts of antibiotic misuse at an individual level. Discussing potential adverse drug reactions, allergic rashes, emergency room visits, antibiotic-associated diarrhea, Clostridioides difficile, and prolonged deleterious effects on the microbiome can provide a more tangible understanding.
Especially with growing awareness about the microbiome’s importance, discussing how antibiotics can disrupt it for months and potentially contribute to conditions like rheumatologic diseases and cancers can help patients comprehend the significance of responsible antibiotic usage. Furthermore, antibiotics ingested during early childhood can potentially set the stage for chronic health issues like asthma, obesity, inflammatory bowel disease, and possibly increase the risk for certain cancers and conditions like Alzheimer’s disease and multiple sclerosis later in life.
Beyond clinicians and other healthcare workers, infection preventionists can significantly contribute to the fight against AMR. Simple interventions like diligent hand hygiene can dramatically reduce the spread of infections within healthcare environments and the broader community. Additionally, an unwavering commitment to vaccination campaigns is equally important, as this not only helps prevent antibiotic-resistant infections but also enhances overall health levels, reduces societal illness burdens, and supports economic stability.
In conclusion, enhancing our preventive measures, persisting in our vaccination efforts, and refining our approach to antibiotic prescription and usage are fundamental to our shared fight against AMR.
Source: https://www.medicaleconomics.com/view/primary-care-fighting-amr-on-the-front-line-of-medicine