The Dangers of Over-Prescribing Antibiotics

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CDC: Over-prescibing Antibiotics promotes stronger More Resilient Bacteria Growth. This new Bacteria Growth is more resistant to medications, and often causes infections and cancer-type skin spots (these spots appear red and brown) that are much more serious than the original infection being treating.

Antibiotic prescribing in hospitals is inconsistent and often inappropriate—contributing to the emergence of antibiotic resistance, according to an analysis of hospital antibiotic prescribing by the US Centers for Disease Control and Prevention (CDC). But simple steps, such as implementing checklists, could help hospitals more wisely use these vital medications, the CDC says.

The CDC has launched an increasingly urgent campaign to combat antimicrobial resistance. A report issued by the agency last fall found that antibiotic-resistant bacteria infect 2 million US individuals each year, causing 23 000 deaths and accounting for $20 billion in health costs. The report also raised the specter of the emergence of untreatable infections.

But in a March press briefing, CDC Director Thomas Frieden, MD, MPH, said that it is possible to reduce drug resistance rates by establishing antibiotic stewardship programs at hospitals and improving coordination between facilities. “We want to develop the infrastructure in every hospital, so every physician knows how to prescribe properly in the context of [his or her] hospital,” said Arjun Srinivasan, MD, associate director for health care–associated infection prevention programs at the CDC.

The US Centers for Disease Control and Prevention advises more judicious use of antimicrobials to treat urinary tract infections, pneumonia, and infections with methicillin-resistant Staphylococcus aureus.

For its part, the CDC is providing checklists for hospitals and physicians. And with the help of an additional $30 million in funding in the Obama Administration’s proposed 2015 budget, the CDC also plans to build an improved surveillance system to rapidly detect the emergence of antibiotic resistance.

More than half of hospital patients receive an antibiotic during their stay, and nearly a third receive a broad-spectrum antibiotic, according to the CDC’s analysis of data from 323 hospitals. These statistics aren’t terribly surprising, but the wide variations among hospitals are. Frieden noted that some of the 26 hospitals reporting data to the National Healthcare Safety Network prescribe 3 times more antibiotics than others.

“This provides a warning bell that improvement is possible,” Frieden said.

The analysis found frequent mistakes in the treatment of common conditions. Using data from its Emerging Infections Program, which included information on about 11 000 patients at 183 hospitals in 2011, the CDC found that half of all antibiotics were prescribed for 3 conditions: lower respiratory infections, urinary tract infections (UTIs), and gram-positive infections that are presumed to be resistant. In a review of 296 cases at 36 hospitals in which physicians treated patients with intravenous vancomycin or treated patients with a UTI who did not have a catheter, the CDC found that more than one-third of those cases involved mistakes that could contribute to resistance. For example, samples were not taken before initiating therapy, doses were incorrect, therapy was not reevaluated after 48 hours, or antibiotics were administered for too long.

“The data on surveillance are no surprise, but it is important to have numbers to support stewardship programs,” said Helen Boucher, MD, a physician at Tufts Medical Center and a member of the Infectious Diseases Society of America’s board of directors. She noted that the society has advocated for better stewardship of antibiotics for years.

More judicious use of antimicrobials in hospitals could have a big effect. Based on its models, the CDC estimates that a 30% reduction in the use of broad-spectrum antibiotics in hospitals—representing a 5% reduction in overall hospital antibiotic use—could prevent 26% of Clostridium difficile infections related to antibiotic treatment. These reductions could also help prevent spillover transmission of C difficile into the community.

To aid all these efforts, the CDC plans to use its anticipated funding boost to build the infrastructure necessary to more quickly identify the emergence of resistant strains. Boucher explained that European public health officials are far ahead of the United States in this regard and can provide detailed information on resistance patterns by country and region.

John R. Combes, MD, senior vice president at the American Hospital Association, said that hospitals recognize the need for improvement and that the association is partnering with other organizations to build a toolkit for stewardship programs.

“We must improve our processes, not only to protect our patients, but to protect our antibiotics,” he said.

STEWARDSHIP INFRASTRUCTURE

The CDC recommends that each hospital build an antibiotic stewardship program to provide physicians with the information and tools they need to make the right decisions.

“Antibiotics are a precious resource, yet for decades we have not had a systematic approach in hospitals across the US to ensure they are used wisely,” said Sara Cosgrove, MD, MS, chair of the Society for Healthcare Epidemiology of America antimicrobial stewardship taskforce, in a statement. “Antimicrobial stewardship programs are a critical step toward stemming the tide of antibiotic resistance and ensuring patients are receiving the right antibiotic, at the right dose and for the right duration.”

The CDC recommends that stewardship programs include 7 components:

  • Dedicated human, financial, and technology resources

  • A physician or other leader responsible for overall outcomes

  • A pharmacist leader focused on prescribing

  • An action to improve prescribing, such as requiring reassessment of prescriptions after 48 hours for drug choice, dose, and duration

  • Monitoring of prescribing and resistance patterns

  • Regular reporting of resistance information to clinicians

  • Education about resistance and judicious prescribing

Boucher, who was hired by Tufts to lead its stewardship program, said that not only were these steps reasonable, but that taking them may also bring other benefits for hospitals. She explained that Tufts has saved millions of dollars by improving its stewardship of antibiotics.

Combes emphasized that the recommendations are not intended to limit physicians’ autonomy but to give them the information they need to provide the best care possible. In an age when “health care has become more of a team sport,” he said, the expertise of pharmacists and infectious disease specialists can help a physician choose the right drug.

“This shouldn’t be viewed as a bureaucratic obstacle to good clinical care,” he said. “This is good clinical care.”

The CDC is also recommending that hospitals work more closely with local public health agencies and neighboring health care facilities to better control the spread of microbes between facilities.

“Our hospitals are just one part of a continuous system of care,” said Combes. Courtesy of: Zedie @ wordpress.com

New AIDS Vaccine Comes in a Capsule

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Wanted: Volunteers to test an experimental new AIDS vaccine that is needle-free. The catch? You have to be willing to stay locked up in your room for 12 days.

The new vaccine comes in a capsule and it’s made using a common cold virus called an adenovirus, genetically engineered with a tiny piece of the AIDS virus.

It’s only a very early stage experiment, meant to show the vaccine is safe. However, if it is, it could be a start not only towards a much-needed vaccine against the AIDS virus, but needle-free vaccines against many different infections.

Researchers at the University of Rochester Medical Center are testing it in their specially designed facility usually used to test live influenza vaccines. The trial, which started Tuesday, is being paid for by the Bill & Melinda Gates Foundation.

“We’ve had success doing this before. The facility is very nice,” says Dr. John…

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How hugs can help fight the flu

Hugs can actually ward off stress and protect the immune system, according to new research from 276347-5e1f6c0e-8867-11e4-a68f-3946861404f8Carnegie Mellon University. It’s a well-known fact that stress can weaken the immune system. In this study, the researchers sought to determine whether hugs — like social support more broadly — could protect individuals from the increased susceptibility to illness brought on by the particular stress that comes with interpersonal conflict. “We know that people experiencing ongoing conflicts with others are less able to fight off cold viruses. We also know that people who report having social support are partly protected from the effects of stress on psychological states, such as depression and anxiety,” the study’s lead author, psychologist Dr Sheldon Cohen, said in a statement. “We tested whether perceptions of social support are equally effective in protecting us from stress-induced susceptibility to infection and also whether receiving hugs might partially account for those feelings of support and themselves protect a person against infection.” In the experiment, over 400 healthy adults who filled out a questionnaire about their perceived social support and also participated in a nightly phone interview for two weeks. They were asked about the frequency that they engaged in interpersonal conflict and received hugs that day. Then, the researchers exposed the participants to a common cold virus, and monitored them to assess signs of infection. They found that both perceived social support and more frequent hugs reduced the risk of infection associated with experiencing interpersonal conflict. Regardless of whether or not they experienced social conflicts, infected participants with greater perceived social support and more frequent hugs had less severe illness symptoms. “This suggests that being hugged by a trusted person may act as an effective means of conveying support and that increasing the frequency of hugs might be an effective means of reducing the deleterious effects of stress,” Cohen said. “The apparent protective effect of hugs may be attributable to the physical contact itself or to hugging being a behavioural indicator of support and intimacy … Either way, those who receive more hugs are somewhat more protected from infection.” If you needed any more reason to go wrap your arms around someone special, consider this: Hugs also lower blood pressure, alleviate fears around death and dying, improve heart health and decrease feelings of loneliness.

 

SOMEONE SOMEWHERE

WE know that hugs make us feel warm and fuzzy inside. And this feeling, it turns out, could actually ward off stress and protect the immune system, according to new research from Carnegie Mellon University. It’s a well-known fact that stress can weaken the immune system. In this study, the researchers sought to determine whether hugs — like social support more broadly — could protect individuals from the increased susceptibility to illness brought on by the particular stress that comes with interpersonal conflict. “We know that people experiencing ongoing conflicts with others are less able to fight off cold viruses. We also know that people who report having social support are partly protected from the effects of stress on psychological states, such as depression and anxiety,” the study’s lead author, psychologist Dr Sheldon Cohen, said in a statement. “We tested whether perceptions of social support are equally effective in protecting…

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DEPRESSION: IT’S NOT YOUR SEROTONIN

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serotoninMillions believe depression is caused by ‘serotonin deficiency,’ but where is the science in support of this theory?

“Depression is a serious medical condition that may be due to a chemical imbalance, and Zoloft works to correct this imbalance.”

Herein lies the serotonin myth.

As one of only two countries in the world that permits direct to consumer advertising, you have undoubtedly been subjected to promotion of the “cause of depression.” A cause that is not your fault, but rather; a matter of too few little bubbles passing between the hubs in your brain! Don’t add that to your list of worries, though, because there is a convenient solution awaiting you at your doctor’s office…

What if I told you that, in 6 decades of research, the serotonin (or norepinephrine, or dopamine) theory of depression and anxiety has not achieved scientific credibility?

You’d want some supporting arguments for this shocking…

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How Often You Really Need To Shower (According To Science)

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Some people see showers as a necessary (and lovely) ritual that all decent human beings do daily…

How Often You Really Need To Shower (According To Science)

While others believe it’s a chore to avoid until the last possible minute and then do as quickly as humanly possible.

How Often You Really Need To Shower (According To Science)

If you’re in this category and have ever wondered how often you actually need to clean your body, the answer is: not as often as most Americans probably think.

Two dermatologists tell BuzzFeed Life that most Americans shower way more than is necessary.

How Often You Really Need To Shower (According To Science)

According to Dr. Joshua Zeichner, assistant professor of dermatology at Mount Sinai Hospital in New York City, how frequently we shower and what we perceive as body odor is “really more of a cultural phenomenon.” Boston dermatologist Dr. Ranella Hirsch echoes this sentiment. “We overbathe in this country and that’s really important to realize,” she says. “A lot of the reason we do it is because of societal…

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