Caitlin Eccles-Radtke, MD:
Stories of Antibiotic Use and Resistance

I am an infectious disease physician and it is my job to help both with prescribing antibiotics, as well as helping others discern when antibiotics aren't needed.

The most challenging thing about antibiotic prescribing and stewardship is changing the culture of providers to not prescribe antibiotics for likely viral infections when it is a patient expectation that they need antibiotics (say, for the common cold).

Every year we are seeing more and more resistant organisms, which is very scary as we will eventually lose all antibiotic options to treat certain infections if we aren’t good stewards of our antibiotics and drug companies don't prioritize the production of new antibiotics.

It affects my work on a daily basis—I work with providers to change prescribing patterns and narrow antibiotics when able in order to decrease use and decrease risk of resistance. For example, we had a patient with a very resistant organism in his urine and he was being seen in the emergency department (ED) and they were worried that it was something that needed treatment right away. We often have to help providers take a step back to take a closer look at a case. For example, this patient had colonization [bacteria present without causing disease] and not a true infection in his urine which didn't require treatment and we had to reassure the ED providers that it was to withhold antibiotics. I think providers are more fearful of these resistant organisms than the public, as I don't think the public is as informed yet.

That we will ultimately be back in the pre-antibiotic era and not have treatments for infections if we are not more careful with our current antibiotic prescribing.

I’d like to know more about how to educate the public, more about better testing to distinguish between viral/bacterial infections, and more about how antibiotic use in the animal population may be playing a role in human resistance.