Some patients pressure docs for antibiotics, LI poll shows

While the abuse and overuse of antibiotics underlies a growing global health concern, a new poll reveals how some people in the greater metropolitan area pressure doctors for the medications — and still others flush leftover pills down the toilet.

Antibiotics are becoming increasingly ineffective scientists at the Centers for Disease Control and Prevention and the World Health Organization contend, a loss that can be traced to a variety of factors, including individual attitudes about the drugs. Some health care analysts argue that the post-antibiotic era has already arrived, emphasizing the emergence of globe circling, multi-drug resistant superbugs as an outgrowth of antibiotic misuse on a massive worldwide scale.

Administrators at South Nassau Communities Hospital in Oceanside commissioned a poll of 600 residents on Long Island and in New York City to better paint a local statistical portrait of how the drugs are being used — and misused — by individuals.

Results, which are to be presented at a news briefing Tuesday, found that 12 percent of respondents acknowledged pressuring health care providers to prescribe an antibiotic. Nearly one-third admitted failing to finish a full course as prescribed by a provider; 10 percent said they used an antibiotic prescribed for someone else or offered their antibiotic to a family member or friend who wasn’t feeling well.

“This has been a problem for a long time,” Dr. Aaron Glatt, said referring to pressure on health care providers to prescribe antibiotics by patients who don’t need them but see them as curealls.

“That’s a key finding and that 12 percent is a really strong number. Patients are pressuring their physicians for antibiotics. I think that number is actually higher,” added Glatt, also a spokesman for the Infectious Diseases Society of America.

Additional findings show that nearly 25 percent of poll participants reported flushing unused antibiotics down the toilet, contributing to the slurry of prescription medications that taint groundwater supplies. Forty-four percent throw the medications in the trash. Twenty percent of respondents acknowledged having unfinished antibiotics in their homes.

“There’s an awful lot of antibiotics lying around in medicine chests and drawers,” Glatt continued. “So many people tell me this, and that they have given antibiotics to their sister or friend. That’s why we have blown the quinolone class.” The quinolones include such antibiotics as ciprofloxacin — Cipro — and about two dozens others.

“There are already potentially deadly infections we can’t treat because of overuse of antibiotics,” Dr. Adhi Sharma, South Nassau’s Chief Medical Officer said in a statement. “We need to stop overprescribing of antibiotics now before they all become useless.”

Dr. David Hyun, senior officer with the Pew Charitable Trust’s Antibiotic Resistance Project, said appropriate and inappropriate use of antibiotics drive the antibiotic resistance problem, which is why responsible stewardship is vital.

“When you take an antibiotic for a specific pathogen you are also exposing all of the other bacteria [in your body] to that antibiotic,” Hyun said, including the so-called good bacteria — the microbiome — in your intestines.

The more exposure bacteria have in general to antibiotics, the greater the likelihood of antibiotic reistance, he said.

Hyun pointed to the proliferation of gram-negative bacteria — tough-to-treat pathogens shaped like rods — that are endowed with genes capable of thwarting the class of antibiotics known as carbapenems. These bacteria are known as CRE for carbapenem-resistant enterobacteriaceae. Infection with CRE can be deadly in weak, hospitalized patients. The bacteria, however, have circled the globe, carried from one geographic location to another by colonized people.

In recent months, the genetic element known as mcr-1, has infiltrated some gram negative pathogens imparting resistance to every known antibiotic, including colistin, a once-shelved medication that was brought back into service to treat superbugs that rebuffed the drugs of last resort.

Three months ago, the CDC reported the case of a Nevada woman who died because the pathogens that infected her carried that gene. The superbugs were resistant to 26 antibiotics, drugs once considered among the most potent in the pharmaceutical armamentarium.