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Using antibiotics appropriately

“Antibiotics are the only class of drug for which the more we use them, the less effective they are going to be. There’s no way around it; we have to minimize use to avoid resistance,” explained North Valley Hospital pharmacist Kyle Bitney.

In addition to the risk of resistance, inappropriate use can have negative side effects. According to Jeffrey Westensee, MD, emergency medicine physician at North Valley Hospital, “Excessive or inappropriate antibiotic use can lead to side effects, unnecessary allergic reactions and even Clostridium difficile (C. diff) colitis (intestinal infections) – it has immediate, serious consequences.”

Dr. Westensee and Bitney are both members of the North Valley Hospital Antibiotic Stewardship Committee, which is an effective way for the hospital to address antibiotic stewardship issues, understand resistance that occurs, and evaluate prescription processes and standards. Dr. Westensee explained, “The program identifies which antibiotics are most appropriate to use for our location based on the microbes causing disease. This helps us to tailor antibiotic use to most appropriately treat patients in this area and decrease the likelihood of resistance.”

Location does matter: Northwest Montana has lower rates of many common infections, including C. diff and MRSA (methicillin-resistant Staphylococcus aureus, commonly known as staph). “Because this is a more isolated area, we have the opportunity to control antibiotic resistance better locally,” said Dr. Westensee.

“Every quarter, the hospital lab submits data that shows trends in drug resistance locally, so that we can address that and avoid antibiotics that are becoming less effective,” Bitney explained. North Valley Hospital is able to immediately address problems to keep infection rates low, and because it is a small hospital in a rural location, the committee is working to stay ahead of the severe problems that are seen in more populated metropolitan areas.

“We try to only prescribe antibiotics when they are necessary and the patient is not experiencing a viral illness, for which antibiotics are ineffective. When we determine that antibiotics are needed, then we prescribe only those that most directly address the bacteria causing that specific infection,” said Dr. Westensee. “This allows us to ensure that the sickest patients are then able to receive antibiotics that are effective and have broad coverage where needed, such as for sepsis.”

Bitney added, “Not every patient is a candidate for antibiotics.” Often, physicians are not able to prescribe antibiotics for viral illnesses such as sore throat, ear infection, upper respiratory illness and sinusitis.

As a final note, both Dr. Westensee and Bitney agree that the spread of infection and viruses can be prevented with simple efforts. “People hear it so much, it’s hard to convey how important it is, but the primary way to prevent illness is to wash your hands,” said Bitney. Westensee added, “Wash your hands – we can’t say it enough. Stay away from public places if you feel sick, and cover your cough. We have a responsibility as individuals to work to prevent the spread of illness.”