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SALT LAKE CITY — The days of your doctor telling you to take all 10 days of your antibiotic medication may be coming to an end.
Within the last five years, doctors from Intermountain Health have become nationally known for their research into antibiotic use. This fall, the medical system was awarded two national grants to research the overuse of antibiotics and ways to educate the public and primary care clinicians about it, as well.
"There's a myth that patients come to urgent care looking for antibiotics; that's not the case. They want something to make them feel better. They are seeking help to ease their symptoms, first," said Dr. Payal Patel, the medical director for antimicrobial stewardship at Intermountain Health and co-investigator on the study. She is also an infectious disease physician.
"We already know that, depending on the situation, that five days of antibiotics can be better than 10 days, especially in terms of side effects," Patel said. "With our work, we're trying to address antibiotic stewardship (making sure that antibiotics are used only when they need to be) in every way that someone comes into our system, often through urgent care."
For the last 20 years, or slightly less, doctors and researchers have become aware that people are being prescribed antibiotics when they do not need them. In recent years, Patel and other doctors have become aware that an estimated 90% of those who received antibiotics for a respiratory infection — laryngitis, tonsillitis, acute ear infections, bronchitis and more — did not need them.
The rarity of death from taking antibiotics when you don't need them is very rare, according to local physicians. But that does not mean there are not significant medical problems with antibiotic overuse, ranging from the relatively benign diarrhea to resistance to the overprescribed antibiotic and other antibiotics. In other words, taking antibiotics when there is no need to do so has impacted a patient's ability to heal from bacterial infections and will do so in the future.
There's a myth that patients come to urgent care looking for antibiotics; that's not the case. They want something to make them feel better. They are seeking help to ease their symptoms first.
– Dr. Payal Patel, Intermountain Health
With the help of a $356,000 grant from Merck, researchers at Intermountain Health will study ways to educate patients about when they do not need antibiotics. Patients do not prescribe themselves antibiotics, however, so they will also provide physicians with technology to see how the number of antibiotics they prescribe compares to their peers. This endeavor has been known to improve practices, according to Intermountain medical personnel.
Intermountain is also a part of a $2.5 million project that will study the amount and effectiveness of antibiotic prescriptions provided to children. This project will research the experiences of children and their families in eight states, including Nevada, Colorado, Arizona, Idaho and more. Patient-Centered Outcomes Research Institute, a well-known nonprofit in the medical field that specifically funds research that will make effective change, funded the grant.
Researchers believe this study will not only be informative but impactful as well.
"This project represents a significant springboard from which we can improve the care for more than 270,000 children with acute respiratory tract infections by promoting the adoption of evidence-based antibiotic prescribing practices throughout our system," said Dr. Raj Srivastava, in a written statement. He is the chief clinical programs officer for Intermountain Health, who is leading the project.
"We look forward to the opportunity this initiative holds to continue to improve our clinical practices and, especially, enhance the health outcomes for hundreds of thousands of children who we provide care for," Srivastava added.
Two years ago, Intermountain was awarded a grant from the Centers for Disease Control and Prevention to study antibiotics overuse. They were not only able to determine that this practice was happening but also that systems needed to be in place to create significant change. After applying some techniques such as creating signs educating patients on when they need an antibiotic and when they do not, doctors saw a 15% decrease in the number of prescriptions provided for upper respiratory tract infections.
That decrease did not last once the grant's terms were complete, however. All was not lost, though. With this Merck grant, Patel and other medical personnel at Intermountain plan to create sustainable processes based on what they learned from the last grant.
"We are a group of researchers who have an interest in antibiotic stewardship. I think it's pretty well-known that we have been doing this work. We were kind of hoping that would benefit us toward getting the grant," Patel said. "We have a strong reputation for antibiotic stewardship within our field ... and we're happy to work on this."
