The reappearance of vaccine-preventable diseases such as measles is not the only significant and preventable health threat facing our families in the U.S. today. Antibiotic resistance is a concerning global threat. The CDC estimates that antibiotic-resistant bacteria cause nearly three million infections and 35,000 deaths each year in the United States. Additionally, some studies estimate that antibiotic use could be safely reduced by 30%. The cost in terms of health care dollars spent on antibiotics is staggering, as high as $35 billion dollars each year. Currently, antibiotics are the most common prescription written for pediatric patients. In January 2021 the American Academy of Pediatrics issued a policy statement on antibiotic stewardship urging pediatricians in the inpatient and outpatient settings to thoughtfully and critically choose antibiotic treatment for children.
Infections acquired in the community such as MRSA or Methicillin-Resistant Staph. Aureus, have become commonplace. Perhaps more concerning is the very real bacterial resistance to drugs commonly used for severe illnesses and resistance to ‘last-line’ drugs previously called upon to treat resistant bacterial infections. We all have a role to play in both the development and the prevention of this frightening epidemic.
Antibiotics have been used inappropriately in the agriculture industry for many years. There is a causal link between the use of antibiotics in agriculture and resistance of human infections to antibiotics. However, that is not the only source of the problem. Studies have shown that as many as 10 million antibiotic prescriptions are written each year for infections where antibiotics are not needed or unlikely to help. Additionally, many families, despite good intentions, fail to take antibiotics as prescribed by their health care providers. This misuse of antibiotics has directly led to the development and rapid spread of antibiotic resistant bacteria.
As pediatricians, we are on the ‘front line’ of the battle against this epidemic. Over 90% of common childhood illnesses are viruses that do not require or improve with antibiotics. Respiratory tract infections (i.e. colds), runny noses, sore throats or coughs are the illnesses and symptoms for which antibiotics are most commonly inappropriately prescribed. Sometimes, this is due to pressure placed on health care providers by well-intentioned but misinformed patients or families. Often, symptoms can linger for up to 10 days, but will resolve with time. Most symptoms can be relieved with simple remedies or occasionally over the counter medications. It is important to remember that these types of illnesses are NOT made better by antibiotics. In addition, antibiotics themselves often cause new symptoms, due to side effects such as stomach aches, diarrhea, yeast infections or allergic reactions. Between 2011 and 2015, antibiotic-associated adverse drug events accounted for almost 50% of emergency department visits of all medication related visits. We will help you to understand how to best manage your child’s symptoms, and when further intervention, such as antibiotics are needed. Your pediatricians and nurse practitioners utilize the many tools, extensive training and knowledge in deciding both when to prescribe antibiotics and which antibiotics to prescribe for your child.
We see it as our responsibility to safeguard not only the current generation from the spread of antibiotic resistance but that of your children’s children as well. We encourage you to help us in this endeavor. We encourage you to talk with us and listen to our advice as to whether antibiotics are appropriate for your child’s illness. We hope you will support efforts to decrease the use of inappropriate antibiotics in manufacturing and agriculture, as well as ongoing efforts for research into prevention of resistant illnesses and development of new antibiotics. Together, we can work to combat this growing and frightening epidemic.
Antibiotic Stewardship in Pediatrics, a policy statement from the American Academy of Pediatrics