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The Pharmacist Point of View...


We have come a long way from the discovery of penicillin by Sir Alexander Fleming a little more than 80 years ago. It’s hard to believe that a happy accident caused by a contaminated culture plate being left out for 2 weeks while Fleming was on vacation led to one of the true medical breakthroughs of modern medicine. And as other antibiotics were discovered and successfully used to treat bacterial infections in humans an entire class of medicine was born. But what happens when our antibiotics don’t work anymore?

Since Fleming made his observations staring at a moldy culture plate we have had many more antibiotics come to market. And people everywhere have benefited from the availability of effective antibiotic treatments. But it seems like these antibiotics we all rely on are being indiscriminately used which may lead to a dangerous scenario where the bacteria become resistant to our treatment options. But has that already happened to some extent and what caused this problem?

It seems like the rule of thumb for modern medicine is simply to dole out antibiotics to anyone that shows up at the urgent care clinic with the sniffles. The doctor is playing it safe by giving the patient an antibiotic just in case and the patient feels like they have done something by getting some medicine from a physician. But is this really the best way to use antibiotics? What happens when we overuse these drugs?

We are becoming so accustomed to using antibiotics freely that often we don’t consider the consequences of the free use of those drugs. What if the antibiotics we have simply lose effectiveness? Can we count on the pharmaceutical industry to bail us out with a continuous supply of new and improved bug killers? The formation of resistant bugs is well documented. Look at the scare that was created by the emergence of methicillin-resistant Staphylococcus aureus. That mouthful is known under the abbreviation MRSA. It started to show up about 15 years ago or so and has become a real health problem. And now there is a new class of superbugs that are carbapenam-resistant. Treatment options for those bugs are limited to combination therapy or an old antibiotic which can be toxic to the kidneys. Have we cornered ourselves clinically by using antibiotics so freely over the years?

It just seems to me that when I see a patient come into my pharmacy from an urgent care they inevitably are given a Z-Pak or Augmentin or Amoxicillin. But what if a lot of these patients have the common cold? I know of urgent care doctors that give antibiotics such as azithromycin for patients with apparent sinus infections and include one or two refills. And access to antibiotics is even easier in some countriesthat sellsomeof themover the counter without a prescription.

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