A Retired Nurse Shares Her Thoughts on Antibiotic Stewardship

Antibiotics are life-saving drugs, but they must be used wisely. They have saved so many people and can continue to do so if we use them the right way. People need to develop a healthy respect for these powerful drugs. And accept that sometimes, being sick is just part of being human.

Marcia Rasner is a member of atom Alliance Patient and Family Advisory council and has been a registered nurse for more than forty years. We recently talked to her about antibiotic stewardship and her experience as a provider in rural Kentucky. She shared her frank and honest observations from her many years in specialty care units, emergency departments, home health, hospice and case management.

“Over the past forty years, I’ve watched the increased use of antibiotics accompany the increase in serious infections. Seems like it should be the other way around, doesn’t it?”

 

 

What have you observed about antibiotics during your time as a nurse?

The overprescribing and overuse of antibiotic drugs has been a concern for years in healthcare where staff are constantly facing pretty nasty infections like C.diff, MRSA, and E. coli.

Some healthcare professionals have been prescribing too many antibiotics. They use a shotgun approach; doctors just give a round of antibiotics not knowing exactly what illness they’re treating, but chances are they’ll hit something.

Where I live, the population tends to be low-income and rarely educated beyond high school. Most people who live here, have always lived here. They’re of the opinion that if you’re sick, you need a pill or a shot. You go to the doctor to get something or have something done to you that will fix it. And they’ll keep going to doctors who they know will prescribe medications.

Why do you think patients are convinced they need a “quick fix” when they’re ill?

People do not want to wait for lab work or test results before starting on antibiotics.

Doctors feel pressured from parents to prescribe immediately for children, without doing a culture to see what a child might actually be sick with. They go ahead and start the child on antibiotics regardless of what ails them. If it’s a virus, those antibiotics are just harming the child’s body for no reason.

“Antibiotic” literally means “against life.” They don’t just attack bad germs in your body, they attack healthy bacteria too. I think it’s fine to use antibiotics, but they need to be used wisely.

So it’s OK to question a prescription or say no to antibiotics sometimes?

Not all illnesses are responsive to antibiotics, they’re not like aspirin. Aspirin will always help pain and inflammation, but antibiotics will not always help an illness. The more antibiotics that you take, the more your body builds up a resistance to those drugs. The bacteria are very smart, they’ll mutate so the drugs don’t kill them anymore.

This has produced a two-pronged dilemma – a person’s body can become resistant to antibiotics AND the bacteria can become resistant to antibiotics mutating to become stronger.

What factors do you see contributing to the overuse of antibiotics?

I think a lack of education about the overuse of these drugs is the biggest problem. If people understood what they were doing, if they understood they were potentially harming their immune systems, perhaps for life, then they’d think twice about using these drugs so freely.

Also, we’re afraid to be sick. Humans are living beings. Living beings, just like a machine, can have something go wrong…something not working right. It’s normal for a person to get sick from time to time.

What is it going to take to get the message out there that these drugs are not to be taken lightly?

I think we need a serious public health educational effort that is honest with people about how dangerous the overuse of antibiotics can be. We must change how patients view antibiotics so they quit seeing them as a harmless cure-all. We need something to help prevent these resistant superbugs.

I don’t think most people know there are superbugs out there now that antibiotics can’t help.

What would you advise patients do to help reduce the use of antibiotics?

Get a Second Opinion

My nephew was continually sick and constantly on antibiotics. I suggested he go to a different doctor because that doctor was not addressing the child’s issues if he wasn’t getting better. The new doctor examined him, and recommended they remove his adenoids and tonsils. Afterwards, the child felt much better, was able to gain some weight and stop taking antibiotics.

Practice and Teach Good Hygiene

People don’t realize that hygiene, rest and the antibiotics all have to work together to fight an infection. Kids on antibiotics are not immune to germs, they still need to wash their hands and stay away from others. You hear handwashing is the best medicine. That really is true.

You have to teach people basic hygiene. If you see a server clear a table at a restaurant by putting their hands inside the rim of a glass, don’t go back there. That’s how germs get spread. If you are sick with any kind of diarrhea, don’t get into a public pool. That’s how disease is spread. This should be common knowledge, but it’s not.

Try to Stay Out of the Hospital

A hospital is not the best place for sick people. If you’re really ill and your system needs support, then you need to be in the hospital. But if you’re sick and you can still get up and go to the bathroom and get yourself some water, then you’re better off at home. There’s a lot a germs in a hospital.

Listen to Your Body and Rest

For me, I know that if I feel something coming on, I can “go to ground” and get rest for about 24 hours, drink a lot of fluids and do nothing but rest. And I will not get any sicker. But we have this “soldier on” mentality where we don’t or can’t give our bodies time to deal with sickness. We need a shift in thinking so that it doesn’t feel wrong to be sick from time to time.


What is Antibiotic Stewardship?

Antibiotic stewardship is a program by which facilities are able to monitor, reduce and prevent misuse and/or overuse of antibiotics within a healthcare system using a multidisciplinary team and strategic approach.

The atom Alliance provides outreach, education and technical assistance to implement the CDC’s Core Elements of antibiotic stewardship in outpatient settings. Our team is working to establish and implement antimicrobial stewardship program activities in outpatient settings that are effective, sustainable and can be tailored to the clinical needs of those settings.

Learn about the work atom Alliance is doing to improve antibiotic stewardship in outpatient settings here.