The overuse of antibiotics, the leading cause of antibiotic resistance, troubled Dr. Jason Newland even before the coronavirus pandemic.
Newland is a professor of pediatrics at Washington University and director of the Antimicrobial Stewardship Program at St. Louis Children’s Hospital.
“We’ve come to a point where most of my colleagues ... can tell you stories of taking care of patients where we were down to the last antibiotic we had,” Newland said. “I've even had the experience of trying to figure out, how do you treat somebody that has an antibiotic that won’t work against the bacterial infection they have? — which is scary.”
Once, a patient of his — an infant born at 24 weeks, weighing just one pound — suffered from a recurring bacterial infection in their bloodstream. Newland and his team were able to treat the baby with antibiotics for a while, but upon the third recurrence of the infection, the drugs didn’t work, and the patient didn’t survive.
This kind of tragic story will become more commonplace, Newland said, as bacteria become more resistant to antibiotics.
“As we put more pressure on the bacteria to treat it with these antibiotics — and if we’re using a lot of it when we don’t need it — all we’re doing is saying, ‘Hey, bacteria, this isn’t going to touch you, but you’re going to become more resistant,’ and then that becomes a problem because then we don’t have that antibiotic to use again,” he said. “Bacteria are smart, and they change quickly. Therefore, they can evolve quickly.”
Newland is especially concerned about the issue now that the pandemic has exacerbated the problem. First, the extreme health needs of the pandemic have caused some physicians and pharmacists to pay less attention to programs that promote the appropriate use of antibiotics. Secondly, some hospital physicians are inappropriately prescribing drugs because they’re trying to do the most for their very ill patients.
“If you have someone that sick coming into your hospital, you have to be worried about them potentially having a bacterial infection on top of [COVID-19],” he said.
A study Newland co-authored, published in the peer-reviewed medical journal Clinical Infectious Diseases, found that in addition to up to half of adults being wrongfully prescribed antibiotics in hospital settings, one in four children given antibiotics in children’s hospitals are prescribed the drugs inappropriately.
On Thursday's St. Louis on the Air, Newland talked about the potentially grave consequences of overusing antibiotics, how inappropriate prescriptions are happening more than ever during the pandemic and what people can do to reduce the problem.
Newland said that as parents and patients, the best thing to do is to list your symptoms, rather than try to guess the issue causing them.
“Be an advocate for the appropriate use of antibiotics,” he said. “We know based on data that if I as a parent go to a clinician and start saying that my child has an ear infection, if I just say those words, that clinician is way more likely to give an antibiotic.”
Which, he added, is not always the right treatment.
Newland said people should also get vaccines when they become available, so as to avoid illnesses that are likely to lead to inappropriate antibiotic prescriptions.
“The prevention of infections such as COVID-19 or influenza aids in reducing the need for antibiotics [and] aids in us using antibiotics more appropriately.”
“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. The audio engineer is Aaron Doerr.
