If you’re sick enough to visit your doctor, you want to leave his or her office with something to help you feel better. While you may prefer the sense of relief that comes with a prescription, sometimes practical advice is the best medicine.
Antibiotic over-prescribing has been a troubling nationwide trend for many years, and BlueCross has been at the forefront of raising awareness of its negative consequences among providers and members in Tennessee. For the past several years, we have supplied educational materials on appropriate antibiotic use, along with flu kits providers can give their patients to help provide symptomatic relief.
Appropriate vs. inappropriate use
Antibiotic over-prescribing does not have malicious roots. Typically, it’s anything but.
Take this scenario: A father has a sick daughter and just wants something to make his little girl feel better. The pediatrician determines the child has a viral infection but prescribes antibiotics to set everyone’s mind at ease, even though the medication won’t get rid of the virus. The father feels better leaving the office with something in hand, and his daughter will feel better in three to five days, whether she received a prescription or not.
Antibiotics are intended to treat bacterial infections, not viral infections.
When antibiotics are overused, the body can become resistant to them, making bacterial infections more difficult to treat. Antibiotics can also cause side effects like diarrhea, skin rashes and yeast infections. Approximately 23,000 people die and 2 million suffer from antibiotic-resistant bacterial infections every year in the United States, according to the Centers for Disease Control and Prevention (CDC).
Bacterial infections such as strep throat, whooping cough or urinary tract infections warrant the use of antibiotics. Your doctor may also recommend antibiotics for a sinus infection, middle ear infection or severe bronchitis.
Illnesses that should not be treated with antibiotics include:
- Common cold or a runny nose
- Sore throat (not diagnosed as strep)
“The primary cause of inappropriate antibiotics use is prescribing these medications for illnesses that are primarily caused by viral infections,” says Jeff Campbell, corporate pharmacy director at BlueCross. “We focus our educational efforts on acute bronchitis in adults and upper respiratory tract infections in children, as the Centers for Disease Control and Prevention reports these conditions are overwhelmingly caused by viruses.”
“When you’re prescribed an antibiotic for these conditions, you’re given a drug you don’t really need.”
Tennessee has one of the highest antibiotic resistance rates in the U.S. It also has one of the highest rates of antibiotic prescribing, according to the 2016 The Health of America Report by the BlueCross BlueShield Association. For prescriptions filled per 100 members, Tennessee ranked No. 4 in standard antibiotics, No. 3 in broad-spectrum antibiotics and No. 5 in pediatric antibiotics.
The appropriate treatment for a virus is to alleviate the symptoms: make yourself comfortable, get some rest, use a cool mist humidifier or saline nasal spray, and drink plenty of fluids.
Beginning in October and continuing through the end of the year, BlueCross pharmacists, nurses and quality teams travel to doctors’ offices across the state and drop off the complimentary kits for adults or children. Our hope is that these kits will not only support providers in their efforts to appropriately prescribe antibiotics, but that doctors will use them to educate their patients, as well. We’re distributing around 10,000 kits in 2017.
The kits include:
- Hand wipes
- Medicated lip balm
- Single dose of acetaminophen (adult kits only)
- Sticker and sore throat lollipop (child kits only)
- Disposable thermometer
- Educational materials about viral illnesses and proper antibiotics use
“These materials are more than just a card that says, ‘You have a viral infection, and here’s something for it,’” Jeff says. “We’re offering guidelines for when to exercise caution before filling a prescription, and what questions you should ask your doctor.”
“Part of our justification for distributing these kits is our understanding that many patients are naturally relieved when they can leave their doctor’s office with something tangible.”
While antibiotics over-prescription is an ongoing healthcare concern, we’ve made progress in our education efforts. The Health of America Report shows that from 2010 to 2016, Tennessee saw a reduction in the number of prescriptions in all three antibiotic categories: standard (12 percent), broad-spectrum (15 percent) and pediatric (18 percent).
“Our goal is to remind providers and members that illnesses such as the flu are caused by a virus, and antibiotics have no effectiveness against viruses,” Jeff says. “We’re hopeful we’ll continue to see the number of unnecessary antibiotics prescriptions dwindle.”
For more information about proper antibiotics use, speak with your physician or call our pharmacists at 1-800-922-1557.