A nonprofit publication of the Kentucky Center for Public Service Journalism

Over-use, over-prescription of antibiotics bad in KY, which leads nation; how to avoid serious infections

An infection-control activist offers a dire warning about drug-resistant bacteria and offers tips on how to protect yourself from these deadly super-bugs in an op-ed piece for the Lexington Herald-Leader.

“There is a war going on, reminiscent of a zombie apocalypse,” writes Dr. Kevin Kavanagh, who is also the board chairman of Health Watch USA. “The insidious agent is spread easily between people; a bite is not required. It does not turn its captors into mindless killing drones but instead, when they least expect it, they are slowly eaten from the inside out.The apocalypse is called drug-resistant bacteria, and so far, modern medicine is failing miserably at stopping it.”

Dr. Kevin Kavanagh

The federal Centers for Disease Control and Prevention reports that at least 2 million Americans are infected with a drug-resistant bacterium every year, and at least 23,000 of them die from it. There are signs that the problem will only get worse.

Kavanagh reports that some projections of the annual death toll from drug-resistant infections will reach tens of millions worldwide, surpassing cancer and heart disease as the leading cause of death. He cites reports from CBS News, BBC, Scientific American and Stat, to name a few.

Antibiotic resistance has been linked to the over-prescription of antibiotics; patients not finishing their entire antibiotic course; overuse of antibiotics in livestock and fish farming; poor infection control in health-care settings; poor hygiene and sanitation; and the absence of new antibiotics being discovered, Andrew Duong reports for InfectionControl.tips.

The overuse and over-prescription of antibiotics is a real problem in Kentucky. Kavanagh writes that Kentucky’s antibiotic use is more than double the usage in other states and that the fluoroquinolone (Cipro, Floxin) class of antibiotics is prescribed at one of the highest rates, often inappropriately.

He adds that health-care providers have a responsibility to be the “gatekeeper[s] of antibiotic usage,” but all too often “succumb to patient pressure.”

“For most common illnesses, antibiotics are not effective,” Kavanagh writes. “They will not work on viruses that cause the common cold nor on the flu. They will also not work on most ‘sinus’ infections.”

Centers for Medicare and Medicaid Services map shows
zip code level rates for antibiotics prescribed per 1,000 fee-
for-service Medicare beneficiaries with Part D coverage in
2016. Dr. Kevin Kavanagh of Health Watch USA calls
Kentucky the “bulls-eye of antibiotic overuse.”

Kavanagh adds details on how misuse of antibiotics can lead to a dangerous gastrointestinal infection caused c. diff (clostridium difficile), which is “almost impossible to get rid of” since it is not only resistant to many antibiotics but can transform into a spore that can remain inactive for years, only to reemerge when the body is in a weakened state.

“You know this is a bad actor when severe cases are being cured (and to a very high degree) by using a tube to place someone else’s feces into the patient’s GI tract,” he writes. “Even the mention of this a decade ago would have been meet with ridicule and disbelief but ‘desperate times call for desperate measures.’ Lucky this one works.”

Kavanagh offers these tips to protect yourself:

▪ Avoid the use of antibiotics whenever possible.

▪ Stay healthy, maintain good hygiene and get your vaccinations.

▪ When seeking health care, ask about a facility’s MRSA (methicillin-resistant staphylococcus aureus) and c. diff rates, and any recent outbreaks of other dangerous bacteria.

▪ Check Hospital Compare, which offers information about the quality of care at over 4,000 Medicare-certified hospitals, to determine the facility’s track record on these measures.

▪ Kavanagh warns that a hospital’s ability to handle these infections doesn’t mean they are good at preventing them. He advocates for a “seek-and-destroy” methodology, similar to the one used by the Veterans Administration and England’s National Health Service.

▪ If you are going for surgery and are not offered a test to see if you are a MRSA carrier, ask for one. If you are told it is not cost effective, he writes, “Remember it is a $10 preoperative test.”

▪ Kavanagh notes that there is “solid evidence that MRSA preoperative screening is needed for most major surgeries” to determine which preoperative antibiotics are needed or if intervention is needed to prevent an infection, called decolonization.

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