By Chris Healey
State lawmakers are working to protect doctors who prescribe antibiotics in excess of recommended guidelines. Those efforts come after the CDC declared antibiotic resistance from antibiotic overuse one of the greatest threats to public health.
The controversy stems from state lawmakers in northeastern states affected by Lyme disease, an amorphous bacterial illness transmitted through tick bites. The Infectious Disease Society of America endorses a four-week antibiotic regimen which they say cures most cases. However, some individuals claim their symptoms persist after the conclusion of antibiotic therapy, a condition called Post Lyme Disease Syndrome.
Individuals reporting Post Lyme Disease Syndrome often harangue doctors for further antibiotic treatment, believing previous treatment was ineffective or inadequate. However, studies on Post Lyme Disease Syndrome indicate persistent infection is unlikely. Instead, lingering perceptions of malaise are likely the result of lasting physiological damage from infection known as sequela. Doctors often resume antibiotic treatment at patient request despite research findings not supportive of continued treatment.
Antibiotics are not harmless therapeutics. They produce negative effects in patients and bacteria alike. Extended antibiotic treatments sometimes lead to severe physiological damage including mitochondrial impairment, aplastic anemia, and Stevens-Johnson syndrome. Unless absolutely necessary, antibiotics should be avoided.
Harm from lengthy antibiotic regimens extend beyond the patient. Prolonged antibiotic exposure allows more opportunity for bacterial selection of respective antibiotic resistance. Bacteria can pass resistance to posterity, complicating treatment in new patients.
A 2013 report released by the CDC served as a call to arms for the medical community concerning the growing threat of antibiotic resistance. The report lists four core actions to stymie resistance. One of the four is improved stewardship – commitment to antibiotic use within established guidelines. The CDC report, and other efforts to increase antibiotic resistance awareness, has placed pressure on health officials to conform to new standards of judicious antibiotic use.
Instead of allowing antibiotic conformity pressure to curb prescriptions, lawmakers have interpreted it as an occupational nuisance in need of remedy. An article in the Wall Street Journal discusses bills in the Vermont and New York state legislature to protect doctors from punishment for over prescribing antibiotics.
There is a clear disconnect between government health officials and state lawmakers. Misguided attempts to protect doctors from antibiotic reform pressures reflect a lack of antibiotic understanding. Health officials must improve efforts to communicate the importance and severity of antibiotic resistance.