Urgent care centers are fueling antibiotic resistance.

Urgent care centers are fueling antibiotic resistance.

Story originally published on WIRED.  

American medicine has known for a while that it has an antibiotics-prescribing problem. It’s routine for the precious drugs to be given in the wrong doses, for the wrong period of time, and for the wrong conditions. All of that adds up to burgeoning antibiotic resistance, which kills 23,000 Americans each year and sends another 2 million to a doctor’s office or a hospital, and costs the United States an estimated $2 billion on each year’s health care bills.

American medicine believes it knows why poor prescribing happens: because physicians fearing bad evaluations from patients or supervisors write prescriptions that aren’t really needed. The missing information has been: Where? To figure out how poor prescribing happens, medicine literally had to track down where it was doing things wrong.

A new analysis of more than 150 million outpatient visits made just in 2014 appears to have pinpointed the problem. Antibiotics are prescribed most freely in places where health care personnel are least likely to have an ongoing relationship with their patients, in urgent care centers, emergency departments, and the kind of clinics you find in big-box stores and drug stores. That’s worrisome, because those sectors of the health care system are growing the fastest—and, because patients have so many options to choose from, are also the most vulnerable to consumer pressure.

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