Although antibiotics have played a critical role in modern medicine, overuse of the drugs has led to a steady surge in antibiotic-resistant bacteria.
This issue has been deadly, with the CDC reporting(www.cdc.gov) that, according to the latest available figures, at least 2 million Americans acquire an antibiotic-resistant infection every year, and 23,000 of these patients die as a result.
To combat this public health threat, the AAFP has joined the CDC, the Pew Charitable Trusts and 11 other national health organizations in issuing a joint statement(www.cdc.gov) saying they stand unified in promoting judicious outpatient antibiotic stewardship to suppress the rise of antibiotic resistance.
In their statement, the groups note that all antibiotic use can lead to antibiotic resistance. And although antibiotics are generally safe, they can carry risks for individual patients.
"For example, antibiotics can cause adverse events ranging from minor side effects to serious allergic reactions," the statement reads, "and antibiotic use increases the potential for a patient to develop an infection caused by Clostridium difficile, which can sometimes cause life-threatening diarrhea."
- The AAFP has joined the CDC, The Pew Charitable Trusts and 11 other national health organizations in promoting judicious outpatient antibiotic stewardship to suppress the rise of antibiotic resistance.
- Last year, the White House announced its goal of reducing inappropriate outpatient antibiotic use by 50 percent by the year 2020, which will require that total outpatient antibiotic prescribing in the United States be reduced by 15 percent.
- The organizations say they "commit to collective action to address this challenge by ensuring the appropriate use of these critical therapies."
The statement references a study published Feb. 26, 2015, in the New England Journal of Medicine(www.nejm.org) that estimated nearly half a million Americans contracted a Clostridium difficile infection in 2011; about 15,000 deaths were specifically attributed to the infection.
Reducing Unnecessary Outpatient Prescribing
In March 2015, the White House announced its goal(www.whitehouse.gov) of reducing inappropriate outpatient antibiotic use by 50 percent by the year 2020. The majority of antibiotics prescribed in the United States are for outpatient use.
During the past year, the CDC and the Pew Charitable Trusts convened a panel of experts to determine a baseline of antibiotic prescribing in the United States and figure out how much of this prescribing is unnecessary.
"Based on current prescribing data, these experts determined that at least 30 percent of overall antibiotic use in outpatient settings is unnecessary," says the statement. Given that figure, total outpatient antibiotic prescribing in the United States would need to drop 15 percent by 2020 to meet the White House goal.
"The majority of this reduction would come from reducing unnecessary use of antibiotics for acute respiratory conditions," says the statement. "These conditions account for 44 percent of antibiotic prescriptions in outpatient facilities, and half of these prescriptions are unnecessary."
Previous AAFP Efforts to Combat Antibiotic Resistance
In July, AAFP News reported on the Academy's response to a request for information from the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria on how to best combat antibiotic resistance.
In a letter to HHS,(4 page PDF) (then) AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., explained that the Academy's policy on antibiotics recognizes that inappropriate use of these drugs poses risks to personal and public health. And as a strong proponent of evidence-based care, the AAFP encourages its members to be judicious with antibiotic prescribing, he said.
"For example, it would be inappropriate to prescribe antibiotics for the management of simple otitis media and sinusitis, as noted in the Choosing Wisely campaign recommendations," Wergin said in the letter, referencing an initiative to decrease use of unnecessary or harmful tests and treatments. "The AAFP acknowledges that all antibiotic prescribing should be based on evidence where possible and on best practices otherwise."
Furthermore, the Academy's policy on the use of antibiotics in food production advocates
- restricting antibiotic use in farm animals to treatment of established disease;
- requiring industry to provide proof of efficacy and a positive cost-benefit analysis for any antibiotics used in food production, with a focus on the total costs to human health; and
- supporting federal legislation intended to accomplish these measures.
Wergin's letter also highlighted how the AAFP has addressed antibiotics and infection prevention in its educational programming, offering a robust list of CME activities on the topic. In the past four years alone, the AAFP CME Credit System has certified 23 activities covering these topics.
AAFP, Other Groups Pledge Continued Collaboration
The joint statement closes with the organizations saying they "commit to collective action to address this challenge by ensuring the appropriate use of these critical therapies."
"In support of national targets, our organizations commit to work in partnership with our members to expand current antibiotic stewardship efforts, fill research gaps around effective interventions for improving prescribing habits and help our members use antibiotics appropriately in outpatient settings," the statement says. "These coordinated efforts will help preserve these life-saving therapies for the good of all of our patients."
Related AAFP News Coverage
AAFP President Spotlights FP Role Against Antibiotic Resistance