Health authorities and pediatricians have joined forces to curb the overuse of antibiotics, a practice that has promoted dangerous bacteria resistant to penicillin and other common "wonder drugs."
In announcing a pilot program yesterday, Maryland Health Secretary Martin P. Wasserman said he was particularly concerned about the spread of drug-resistant pneumococcal bacteria, organisms that can cause meningitis, blood infections and pneumonia.
"The continued spread of antibiotic-resistant bacteria will have a devastating impact on our ability to fight common infections," Wasserman said at a news briefing yesterday.
Wasserman said 15 percent of all pneumococcal illnesses in Maryland are drug-resistant, about three times the rate in the 1980s. He blamed that on the growing tendency of doctors to prescribe antibiotics for viral illnesses such as colds, coughs and common sore throats, even though the drugs are effective only against bacteria.
Children afflicted with the new strains of pneumococcal diseases are sick much longer and often try several antibiotics before one proves effective. Many require hospitalization.
The campaign is a project of the health department, the Maryland chapters of the American Academy of Pediatrics and the American Academy of Family Physicians, the Johns Hopkins School of Public Health and the federal Centers for Disease Control and Prevention.
Bacteria assaulted by antibiotics have a natural tendency to develop resistance. The more frequently antibiotics are used, the greater the likelihood that will happen. The risk is not only to the patients taking the drugs, but to people who catch the resistant strains from others.
A case in point is 3-year-old Ariana Broadway of Randallstown, who spent 10 days in Sinai Hospital last year with a blood and lung infection that didn't respond to front-line antibiotics. She was given four before one worked.
It took her several months to completely recover from the infection, which was caused by a resistant pneumococcal strain.
Before getting sick, Ariana was not being treated for anything. She apparently caught the resistant bug from someone else.
"It was the most dreadful time in my life," her mother, Lisa Broadway, said at yesterday's briefing.
Educating the public
A central feature of the campaign is physician education. Doctors trained to teach other doctors are fanning out to pediatricians' offices in Baltimore and in Howard, Anne Arundel, Harford, Carroll and Baltimore counties. They plan to hold seminars in two-thirds of the pediatric offices in the area.
Pamphlets to educate the public are being placed in doctors' offices. They emphasize that colds and most coughs, sinus infections and sore throats are viral and should not be treated with antibiotics.
Day care centers are also being targeted.
"We'd like to change that dogma that sick children always need to be on antibiotics before they can return to day care centers," said Dr. Bernadette Albanese, an infectious disease specialist at the Johns Hopkins School of Public Health. She is directing the campaign, called Judicious Use of Antibiotics.
Dr. Daniel J. Levy, president of the Maryland chapter of the American Academy of Pediatricians, said doctors often prescribe antibiotics against their better judgment because they want to do something to satisfy parents.
rTC "There's increasing pressure on us for a quick fix," Levy said. "They want their children to get better quickly, and they're in a panic. It's really difficult to see a child suffer."
Another common misconception is that antibiotics should be used to prevent bacterial illnesses that can arise from less severe viral illness. "You cannot use an antibiotic to prevent these things from happening," Levy said.
Nationally, antibiotic use increased 50 percent from 1980 to 1992, even though the need for those drugs did not increase, according to Hopkins' figures.
Pub Date: 1/24/98