User login
"Superbugs" is a catchy term, and one that piques the interest of many patients. It gives the microbes a certain mystique, an unusual, sometimes unharnessed power to seek out and destroy.
Physicians come into contact with so many drug-resistant organisms that some have become virtually immune to that bright contact isolation sign on the door. They boldly enter the rooms unprotected, mistakenly believing that as long as they don’t touch anything, they will be safe. But, even when you just want to ask the patient a quick question or two and donning a gown and gloves is cumbersome, it’s extremely important nonetheless.
According to UpToDate, the environments in these rooms are often highly contaminated with notorious organisms, such as MRSA, VRE, and the dreaded C. diff., and one can become exposed to them without ever even touching the patient.
You know what happens next: The bugs are taken from room to room. They are carried into the nurses’ station, where a brief brush against the counter deposits fresh inocula for others to spread. They are deposited on computers, where physicians, nurses, and even case managers work, only to be picked up to by unwary workers (who practice great hand hygiene) and spread around even further. And ultimately, they are taken home on our clothing, making yet another leap when our spouses or children greet us at the door with a big bear hug.
We see the devastation these bacteria have on the lives of our patients and their families, but now they are getting the attention of a much higher authority. The Obama administration recently unveiled its proposal to increase spending to combat antibiotic-resistant microorganisms in hospitals. Specifically, the Centers for Disease Control and Prevention seeks $30 million to fund specialized labs in five areas of the United States to assist local hospitals in diagnosing and combating these infections; it also calls for all hospitals to develop a program to track and improve antibiotic prescribing.
Yes, top-down politics (and medicine) has a very important place. But we are the foot soldiers, the ones who actually take care of patients and prescribe (and sometimes overprescribe) the antibiotics that put them at risk for developing drug-resistant organisms. No doubt, responsible antibiotics stewardship saves lives. Most of us have encountered at least one unfortunate patient who, as a result of antibiotics, developed fulminate C. diff and required a partial colectomy, changing his life forever.
While it may be tempting to continue the broad-spectrum antibiotics that rescued a septic shock patient from the brink of death, if the culture results provide a clear path to streamline treatment and narrow the spectrum, be diligent about making the change. If you think, "In my experience, a patient generally does well continuing on broad-spectrum antibiotics for the course of her treatment," think again. Chances are we will not be the ones readmitting that patient a few weeks later with a new case of sepsis – drug-induced sepsis from the C. diff we predisposed her to.
In addition to our practicing good antibiotics stewardship, educating our patients on the proper use for (and of) antibiotics will empower them to have a role in this battle as well. We have a long way to go in this battle against drug-resistant organisms, and everyone has a part to play.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS. Reach her at [email protected].
"Superbugs" is a catchy term, and one that piques the interest of many patients. It gives the microbes a certain mystique, an unusual, sometimes unharnessed power to seek out and destroy.
Physicians come into contact with so many drug-resistant organisms that some have become virtually immune to that bright contact isolation sign on the door. They boldly enter the rooms unprotected, mistakenly believing that as long as they don’t touch anything, they will be safe. But, even when you just want to ask the patient a quick question or two and donning a gown and gloves is cumbersome, it’s extremely important nonetheless.
According to UpToDate, the environments in these rooms are often highly contaminated with notorious organisms, such as MRSA, VRE, and the dreaded C. diff., and one can become exposed to them without ever even touching the patient.
You know what happens next: The bugs are taken from room to room. They are carried into the nurses’ station, where a brief brush against the counter deposits fresh inocula for others to spread. They are deposited on computers, where physicians, nurses, and even case managers work, only to be picked up to by unwary workers (who practice great hand hygiene) and spread around even further. And ultimately, they are taken home on our clothing, making yet another leap when our spouses or children greet us at the door with a big bear hug.
We see the devastation these bacteria have on the lives of our patients and their families, but now they are getting the attention of a much higher authority. The Obama administration recently unveiled its proposal to increase spending to combat antibiotic-resistant microorganisms in hospitals. Specifically, the Centers for Disease Control and Prevention seeks $30 million to fund specialized labs in five areas of the United States to assist local hospitals in diagnosing and combating these infections; it also calls for all hospitals to develop a program to track and improve antibiotic prescribing.
Yes, top-down politics (and medicine) has a very important place. But we are the foot soldiers, the ones who actually take care of patients and prescribe (and sometimes overprescribe) the antibiotics that put them at risk for developing drug-resistant organisms. No doubt, responsible antibiotics stewardship saves lives. Most of us have encountered at least one unfortunate patient who, as a result of antibiotics, developed fulminate C. diff and required a partial colectomy, changing his life forever.
While it may be tempting to continue the broad-spectrum antibiotics that rescued a septic shock patient from the brink of death, if the culture results provide a clear path to streamline treatment and narrow the spectrum, be diligent about making the change. If you think, "In my experience, a patient generally does well continuing on broad-spectrum antibiotics for the course of her treatment," think again. Chances are we will not be the ones readmitting that patient a few weeks later with a new case of sepsis – drug-induced sepsis from the C. diff we predisposed her to.
In addition to our practicing good antibiotics stewardship, educating our patients on the proper use for (and of) antibiotics will empower them to have a role in this battle as well. We have a long way to go in this battle against drug-resistant organisms, and everyone has a part to play.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS. Reach her at [email protected].
"Superbugs" is a catchy term, and one that piques the interest of many patients. It gives the microbes a certain mystique, an unusual, sometimes unharnessed power to seek out and destroy.
Physicians come into contact with so many drug-resistant organisms that some have become virtually immune to that bright contact isolation sign on the door. They boldly enter the rooms unprotected, mistakenly believing that as long as they don’t touch anything, they will be safe. But, even when you just want to ask the patient a quick question or two and donning a gown and gloves is cumbersome, it’s extremely important nonetheless.
According to UpToDate, the environments in these rooms are often highly contaminated with notorious organisms, such as MRSA, VRE, and the dreaded C. diff., and one can become exposed to them without ever even touching the patient.
You know what happens next: The bugs are taken from room to room. They are carried into the nurses’ station, where a brief brush against the counter deposits fresh inocula for others to spread. They are deposited on computers, where physicians, nurses, and even case managers work, only to be picked up to by unwary workers (who practice great hand hygiene) and spread around even further. And ultimately, they are taken home on our clothing, making yet another leap when our spouses or children greet us at the door with a big bear hug.
We see the devastation these bacteria have on the lives of our patients and their families, but now they are getting the attention of a much higher authority. The Obama administration recently unveiled its proposal to increase spending to combat antibiotic-resistant microorganisms in hospitals. Specifically, the Centers for Disease Control and Prevention seeks $30 million to fund specialized labs in five areas of the United States to assist local hospitals in diagnosing and combating these infections; it also calls for all hospitals to develop a program to track and improve antibiotic prescribing.
Yes, top-down politics (and medicine) has a very important place. But we are the foot soldiers, the ones who actually take care of patients and prescribe (and sometimes overprescribe) the antibiotics that put them at risk for developing drug-resistant organisms. No doubt, responsible antibiotics stewardship saves lives. Most of us have encountered at least one unfortunate patient who, as a result of antibiotics, developed fulminate C. diff and required a partial colectomy, changing his life forever.
While it may be tempting to continue the broad-spectrum antibiotics that rescued a septic shock patient from the brink of death, if the culture results provide a clear path to streamline treatment and narrow the spectrum, be diligent about making the change. If you think, "In my experience, a patient generally does well continuing on broad-spectrum antibiotics for the course of her treatment," think again. Chances are we will not be the ones readmitting that patient a few weeks later with a new case of sepsis – drug-induced sepsis from the C. diff we predisposed her to.
In addition to our practicing good antibiotics stewardship, educating our patients on the proper use for (and of) antibiotics will empower them to have a role in this battle as well. We have a long way to go in this battle against drug-resistant organisms, and everyone has a part to play.
Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS. Reach her at [email protected].
