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January 20, 2014 at 9:00 AMComments: 0 Faves: 0

New "Nightmare Bacteria" Strain: What You Should Know

By Jeffrey VanWingen M.D. More Blogs by This Author

Recently, the Center for Disease Control (CDC) published a warning regarding the rampant spread of what is being termed as the "nightmare bacteria" - carbapenem-resistant Enterobacteriaceae (CRE) - which most often involves infection of the urinary tract, often in sick or hospitalized patients with long-standing catheters in their bladders.

Since its one state appearance in 2001 this multi-drug resistant bacteria has spread to 46 states and killed upwards of 600 people in the last couple years. As the name implies, the bacteria is resistant to carbapenem which is often held in reserve as a "last resort" antibiotic. As a result, it is very difficult, if not impossible to treat. 

Without doubt, this is scary.  It's scary not only because of the number of deaths occurring as healthcare professionals stand by defenseless but also because of its rate of spread and potential for becoming even more severe. Of course, the media has received this report and are doing what they seem to do best, spreading fear.

As I talk to my fearful patients, the above message has been received but an important one seems to have been passed over - that WE did this. In every doctor's office, of every state, over the past years, overuse of antibiotics has created this problem.

As such, I'd like to talk about the overuse of antibiotics and what proper use is in this cold and flu season.

Antibiotic-Resistance Today

Treating common bacterial infections (such as urinary tract infections, pneumonia and skin infections) is no longer as simple as "this infection equals this antibiotic" for doctors today. We've learned the hard way that we must cautiously weigh the seriousness of the infection, speculate on the best chances for success with a certain antibiotic is, and consider whether we should culture the bacteria in a lab to test it.

None-the-less, statistical reports from the CDC show that over 2 million illnesses and 23,000 deaths occur annually in the U.S. due to antibiotic resistance. And as a result of more  difficult to treat  antibiotic-resistant infections our already strapped healthcare system has been further burdened.

What To Expect

While large-scale research efforts are certainly important, the tiny, individual doctor's office that sees infections on a daily basis is equally important in combating this problem. Do you or your child actually need an antibiotic? Basically this boils down to whether an infection is related to a virus or a bacteria.  While science tells us that in fact most ear infections, upper respiratory infections and bronchitis is related to a viral infection - not a bacterial infection for which antibiotics are necessary - the antibiotic tradition is slow to change and many patients still expect and even demand a prescription regardless.

If you have symptoms of an infection such as respiratory, skin or urinary tract do not hesitate to consult your healthcare provider. They can use their expertise to determine if symptoms are actually being caused by a bacteria and warrant an antibiotic. Expect that a culture may be done and an antibiotic may not be given unless bacteria is found.

A General Guide to Antibiotics

Treatable without Antibiotics: When it comes to respiratory infections, the following symptoms can be observed and treated symptomatically:

  • runny nose (no matter the color)
  • cough (with or without mucous)
  • ear pain
  • fever
  • sinus pressure

Serious Symptoms: Call your healthcare provider if you observe the following:

  • difficulty breathing
  • significant wheezing
  • persistence beyond 10-12 days
  • rapid worsening

Skin infection or urinary symptoms: In general, significant skin infection and urinary symptoms should be evaluated.

If you do need an antibiotic: With antibiotic use, please abide by appropriate administration.  Take the full course to prevent recurrence and resistance.  Do not use old prescriptions to treat presumptive infections and do not share prescriptions with others.

Sometimes just a phone call is needed to your healthcare providers office is needed to review the symptoms for reassurance and suggestions on the treatment of symptoms.  Remember, the best treatment that you have is your body's immune system and taking care of this with adequate rest and nutrition is paramount.

Fighting Antibiotic-Resistant Bacteria

Infections are scary business and it's only getting more scary.  To curb these concerning trends, healthcare providers and the public are being asked to use antibiotics more judiciously to treat infections. While we all want the best treatment and may presume that bringing out the "big guns" of powerful antibiotics is the best approach, this is not the case.  Rest assured that careful consideration and often watchful waiting and treatment of symptoms is for the most part the best course.  

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