ACEP seeks to increase public understanding of the growing health problem caused by inappropriate use of antibiotics

Washington, D.C. — The spread of a potentially life-threatening antibiotic-resistant staph germ that is responsible for more deaths in the United States each year than the AIDS virus has prompted the American College of Emergency Physicians (ACEP) to launch an education initiative aimed at protecting the public against the further spread of infection.

“This emerging ‘super bug,’ as it’s known, is causing ACEP to mobilize for two reasons,“ said Linda Lawrence, MD, FACEP, president of the American College of Emergency Physicians (ACEP). “First, we are concerned about the possible spread of this potentially dangerous bacterium – especially in schools, nursing homes and health-care settings – so we are asking people to practice good hygiene, such as frequent hand-washing, to help prevent public outbreaks. Second, ACEP is cautioning against the continued widespread inappropriate of antibiotics, a practice that has in part caused drug-resistant germ strains like this one to emerge.”

At the same time, emergency physicians across the country are on the lookout for cases of antibiotic-resistant infections so these patients can be isolated and treated with the few types of antibiotics that remain effective, before developing potentially life-threatening complications or spreading their infection to others.

A Once-Harmless Pathogen Turned Dangerous
According to the Centers for Disease Control and Prevention in Atlanta, the potentially deadly bacterium, known as methicillin-resistant Staphylococcus aureus (MRSA), has become impervious to front-line antibiotics, such as penicillin, and is becoming more widespread than public health authorities had thought. The microbe, a strain of a common, previously innocuous staph germ, was responsible for 94,000 serious infections and nearly 19,000 deaths in 2005 – surpassing deaths from AIDS by more than 6,100 cases, according to an estimate published in the Oct. 17, 2007, Journal of the American Medical Association (JAMA). African Americans, the elderly and very young children are more susceptible to MRSA infection than the general population.

In addition, a separate report, published in the same JAMA issue, indicates that a strain of another microbe, Streptococcus pneumoniae, which causes ear infections in children, has become resistant to all antibiotics approved for pediatric use.

“Taken together, these two reports reveal the need to develop stronger antibiotics that can effectively combat these common but potentially deadly infections while also illustrating the dangerous consequences of the inappropriate of antibiotics,” said Dr. Lawrence.

Educating the Public
Because of these interrelated concerns, ACEP is seeking to protect the public against drug-resistant infections while at the same time educating people on knowing when – and when not – to seek treatment with antibiotics for a range of illnesses.

“Many sick people come to the emergency department and want to leave with a prescription for antibiotics,” said Dr. Lawrence.  “People need to realize that they should not be seeking antibiotics for colds or flus because these illnesses are caused by viruses, which do not respond to antibiotics. We need to educate our patients and the public about why the inappropriate use of antibiotics is contributing to a public health problem.”

Knowing When to Seek Medical Treatment
Because MRSA is easily spread by casual contact and can rapidly develop into serious life-threatening health conditions, Dr. Lawrence advised that minor abscesses, boils and other skin infections be monitored and treated promptly with antibacterial medications and good hygiene practices. She said patients should seek medical attention if these conditions persist, become progressive, painful or disfiguring, or if the patient develops a fever or other more serious symptoms of illness.

Dr. Lawrence also stressed the importance of “combining caution with common sense. The public needs to remember that staph germs are a common cause of infection, and that 25 to 30 percent of people carry staphylococcus bacteria in their bodies. The difference is that the invasive MRSA strain can become fatal because it has become resistant to most antibiotics,” she said.

In addition, Dr. Lawrence pointed out that “many of these infections can be treated, if caught early enough, by applying heat compresses and lancing and draining sores, and by administering certain appropriate medications. The key is to prevent the germ from spreading to the lungs, vital organs or the bloodstream, where it can cause life-threatening illness,” she noted.

Prevention:  the Best Medicine
Of course, the best protection is always prevention. Among the steps the public can take to prevent MRSA:

• Practice good hygiene by frequently and thoroughly washing hands with soap and hot water or using a skin sanitizer containing topical alcohol. 
• Clean and disinfect cuts, abrasions, punctures and other wounds, and cover them with a bandage. 
• Avoid contact with other people's open skin wounds, bandages or infections. 
• Avoid sharing towels, razors, make-up applicators and other personal-care items that can transmit germs.
• Wash any potentially exposed linens and clothing items in hot water and dry in a hot dryer, if possible, to prevent the spread of MRSA germs. 
• Clean and disinfect items and surfaces that come into frequent contact with skin (such as door knobs, faucet handles, phones, keyboards and workout benches). 
• Seek prompt medical attention for any wound or condition that shows signs of infection (e.g., fever, swelling, redness, or bad smell, fluid draining from the area or increasing pain).
• Be aware that common staph germs are more prevalent in public facilities, so more frequent adherence to good hygiene in such settings is recommended.

ACEP is a national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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