An Analysis of the Public Understanding of Antibiotics and Antibiotic Misuse

Josiah Nelson, Zoology Major

Natural Resources and Conservation Sciences Field Assistant

North Dakota State University

Submitted to Dale Sullivan, September 27, 2010

Abstract

Antibiotics are arguably the most important discovery ever made in medicine. In the early years of their use, antibiotics were seen as “miracle drugs”. However, in the time since their discovery the miracle has faded into an evolutionary arms race between scientists and doctors developing new antibiotics and their bacteria foes. In his book “The Antibiotic Paradox”, Dr. Stuart Levy states, “The seemingly endless miracles attributed to these drugs have led to their misuse and overuse. Bacteria responded to the widespread application of antibiotics by finding ways to become resistant, in other words, insensitive to the killing effects of these powerful drugs.” [3] The proposed study will provide an assessment of the general public’s knowledge of antibiotics and antibiotic misuse. The results of this study will aid in providing an educational focus for English 324 online media.

Introduction

“Resistance originates as a local phenomenon but can expand to global proportions [1].”

Antibiotic resistance today is a result of increased production and distribution of antibiotics. This has led to the creation of multiple resistant bacteria by the accumulation of genetic resistance determinants. This multiple resistance has led to therapy being unsuccessful even against common organisms such as E. coli and Staphylococcus. Some species that are resistant to newer drugs are emerging at an increased rate probably due to environments already contaminated with antibiotics. Newer drugs meant to fight this resistance can cause problems of their own, sometimes producing side effects that limit their use and cause irreversible tissue damage. Failure to stop the spread of antibiotic resistance compromises the health of our community. Increasing numbers of multiply-resistant pathogens are appearing in hospitals and outpatient clinics. This problem was traditionally only seen in large city hospitals. [2] This is a problem that needs to be addressed more publicly so that steps may be taken to curb the spread of antibiotic resistance. The proposed study and its results will be used as a valuable educational tool that can be presented to the public via the English 324 website.

Background

Since their discovery in the early 1900’s, antibiotics have been widely produced and distributed. In 1998, approximately 50 million pounds of antibiotics were produced in the United States alone. About half of this was used in hospitals and homes, most of the rest being used for treating animals. Unfortunately, misuse of these drugs has led to antibiotic resistance, rendering the drugs ineffective. [1] “Although the antibiotic agent is an important factor impacting antibiotic resistance, its selective role relates not only to the total amount, but how it is being used. The same antibiotic provided in different ways can have significantly different effects on antibiotic resistance [1].” Observers have documented antibiotic misuse with cases of physician-written prescriptions for diagnoses that lacked appropriate suspicion of bacterial infection, including a study that used a medical student with a simulated illness. Another study surveying antibiotic usage in hospitals in Pennsylvania found that in surgical prophylaxis, 20 to 25 percent of antibiotic misuse was unnecessary. [2]

Antibiotic resistance can also be linked to resistance to household antibacterial products. There are over 300 nonprescription products on the market today that contain antibacterial agents. This widespread overuse of antibiotic chemicals has contributed to increased antibiotic resistance. [1] The initial problem of resistance has continued to snowball into more serious issues. “Alongside the widely recognized multiply-resistant enteric organisms have now appeared new strains of enterococci which are resistant to all antibiotics currently available, even the most recently developed cephalosporins. While there is general recognition among medical personnel that the problem of antibiotic resistance exists, there is also apathy and/or hopelessness in changing the situation [2].”

Objective

The purpose of this study will be to provide a baseline of information on the general publics’ understanding of antibiotics and antibiotic resistance for the English 324 class to use in the website building process. The information gathered in this survey would aid in ensuring that the information posted to the website will be meaningful and helpful to future website visitors which will keep the focus of the website educational. Other English 324 teams or individuals will be able to use the information found in this survey when working on their own projects to ensure that more in depth information used in website building is presented in a form that is readable to the antibiotic layman.

The overreaching objective of the study is to help maintain an educational focus to the English 324 class website. Maintaining an educational focus to the website will aid in promoting public awareness and concern for the issue of antibiotic misuse.

Method

This study will utilize information gathered from a short survey done in simple question and short answer form (See Appendix A). The survey will be completely voluntary and anonymous to protect the privacy of those surveyed. A minimum sample size of 15 people will be used and there will be no bias in the demographic of those surveyed. The results of the survey when completed will be compiled, analyzed, and reported to the English 324 class. Other English 324 teams or individuals may be permitted to submit questions to be added to the survey so that information may be gathered for use in their own projects. The results of the survey would also be reported and submitted in a scientific research report form for final submission.

Projected Schedule

To curb the spread of antibiotic resistance there must be public concern for the issue at a local and global level. By slowing antibiotic misuse, we may see a reduction in resistance. Less money would need to be spent on the development of newer drugs and it could be possible that some older antibiotics may become more effective. [2] The study proposed here would prove to be a valuable tool in educating the public and raising concern for the misuse of antibiotics. “It is only by raising concern at the level of all individuals that this over-utilization of antibiotics can be eliminated and the re-establishment of an environment low in resistance genes can be realized [2].”

References

1. Levy, Stuart B. "Antibiotic Resistance: Consequences of Inaction." Clinical Infectious Diseases 33.3 (2001): S124-129. Print.

2. Levy, Stuart B. "Antibiotic Resistance." Infection Control 4.4 (1983): 195-97. Print.

3. Levy, Stuart B. "Preface to the First Edition." Preface. The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Power. Cambridge, MA: Perseus Pub., 2002. Xiii. Print.
Appendix A: Survey Questionnaire (Preliminary Draft)

1. Are you familiar with the concept of antibiotic resistance?

(Circle One) Yes / No

2. Have you ever been prescribed an antibiotic?

(Circle One) Yes / No / Unsure

3. If yes to question, did you use the drug for the full extent of the prescription?

(Circle One) Yes / No

4. Have you ever asked a doctor to prescribe an antibiotic for common cold or flu symptoms?

(Circle One) Yes / No

5. Do you regularly use antibacterial soap or other cleaning products with antibacterial agents in your home?

(Circle One) Yes / No / Unsure

6. Would you be interested in learning about antibiotics and antibiotic resistance?

(Circle One) Yes / No / Maybe

Thank you for completing this survey.