Cutting Back on Antibiotics
Antibiotics were an incredible scientific discovery back in 1928, and they subsequently enabled doctors to fight such dangerous bacterial infections as pneumonia. But, as we human beings tend to do with so many things, we overdid it. In fact, antibiotics have become so overused that certain forms of bacteria have developed resistance and become deadly…in fact, almost untreatable. Yet there are still plenty of physicians willing to write out a prescription as soon as a patient begins complaining. In an attempt to limit prescription writing and to focus on building a healthy immune system in patients, researchers developed a test based on a clinical score for patients presenting with a sore throat, and it appears to be able to greatly curb the use of antibiotics.
The study, which took place at the University of Southampton in the United Kingdom, found that antibiotic use was decreased by close to one-third when this test was performed--and patients actually recovered from their ailments faster.1 The FeverPAIN scoring system the scientists used consists of five elements a healthcare professional needs to consider: fever in the past day, the presence of pus, the rapid onset of symptoms, tonsil inflammation, and no coughing or other typical signs of a cold.
The experiment had medical professionals use the FeverPAIN results before either offering an antibiotic prescription on the spot or delaying the prescription for a three to five day period, at which time patients could fill it if their symptoms had persisted. When the FeverPAIN test was applied, antibiotic use was cut by nearly 30 percent. Importantly, those subjects who were assessed according to these criteria reported a greater improvement in their sore throats even without antibiotics since their illnesses were likely viral.
The research subjects were 631 patients who sought medical attention to treat an acute sore throat. The only participants who were given a prescription right away were those who displayed at least four out of the five FeverPAIN criteria. Those participants meeting two or three of the criteria were provided with a delayed prescription, and those with one or none of the symptoms were denied antibiotics altogether. When compared to simply providing a delayed prescription to be filled in a few days if the symptoms had not resolved, the FeverPAIN testing resulted in a 29 percent decrease in antibiotic use. One third of the patients assessed using FeverPAIN reported that their moderate sore throat symptoms had improved to become very minor by two to four days after their examination, so antibiotics were never needed. Even those with more severe initial symptoms said their recovery was substantial enough in the first few days to not require antibiotics either.
And interestingly, scoring based on sore throat symptoms was found to be slightly more effective in determining when antibiotics might truly be beneficial than even the use of a rapid antigen test. The rapid antigen test is provided in the doctor's office with immediate results to determine whether Lancefield Group A Streptococcus--the most common cause of a sore throat--is present. But when this was performed in addition to the FeverPAIN scoring, it did nothing to lower antibiotic use further. In fact, the improvement of symptoms was the same, and there was only a 27 percent lower use of antibiotics with rapid antigen testing--meaning slightly more antibiotics were used compared to FeverPAIN scoring alone.
Anything that can move us in the right direction--that is, away from antibiotics unless they are absolutely essential--is important to consider. And the Centers for Disease Control and Prevention appears to be on board with dramatically cutting the use of these drugs. Let's hope it's not too late. According to Dr. Arjun Srinivasan, Associate Director of the CDC, over prescribing antibiotics has affected many patients who once had a healthy immune system. Dr. Srinivasan said, "We have reached "the end of antibiotics, period. We're in the post-antibiotic era. There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can't…"2
So it would seem that healthcare officials in the United States are finally reaching the conclusion that we need to move away from treating with antibiotics as quickly and thoroughly as we can. Hopefully, other cures will be found for the super-bugs we have created through antibiotic overuse, and also let us hope we will have learned enough so that we don't make the same mistakes again.
- 1. "New Test for Patients With Sore Throats Cuts Antibiotic Use by Nearly a Third." Science Daily. 8 November 2013. Accessed 13 November 2013. http://www.sciencedaily.com/releases/2013/11/131108102333.htm
- 2. "Dr. Arjun Srinivasan: We've Reached 'The End of Antibiotics, Period'." PBS. 22 October 2013. Accessed 15 November 2013. http://www.pbs.org/wgbh/pages/frontline/health-science-technology/hunting-the-nightmare-bacteria/dr-arjun-srinivasan-weve-reached-the-end-of-antibiotics-period/