THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 547.4 Guest: Dr. Martin Wasserman, Maryland Health Commissioner Topic: Antibiotic resistant bacteria initiative Producer/Host: Steve Girard

NEMA: We're coming full circle...bacterial infections used to be deadly at times...since the evolution of antibiotics we've been able to beat such infections. Now things have changed...for the worse. We're talking with Dr. Martin Wasserman, Maryland's chief health officer.....

WASSERMAN: Because of behaviors of both medical providers and patients, we have been seeing an increased number of resistant infections...that are resistant to antibiotics. We decided that this year, our association, the Association of State and Territorial Health Officials, would work with the American Medical Association, the Centers for Disease Control, various other groups, to try to see if we could change the behaviors of providers and patients in America to improve this situation. An example is that back ten years ago, one particular germ strain, the common strain for ear infections and pneumonia and other more serious infections, you could treat with common antibiotics...inexpensive, and relatively accessible antibiotics...9,998 out of 10 thousand infections. Today, in some parts of the country, 30% percent of those germs resist normal, routine antibiotics.

NEMA: People aren't aware of what bacterial infections did before antibiotics, and we don't have a respect for the drugs....

WASSERMAN: We've built in our culture the expectation that if we have a cold or a cough, we'll go to the doctor, and we'll force, and I mean force the doctors to give us some form of treatment. We need to get to think more about non-medicinal remedies for what we call viral infections. There are two types of germs that cause, often, respiratory symptoms - colds and coughs. Viruses, which are the common cold and then, bacteria...which often cause about 50% of middle rear infections - it can also cause pneumonia. In those situations, where only a doctor can distinguish between a virus and a bacterial infection, we shouldn't go and start treating, or forcing others to treat us with antibiotics.

NEMA: But when we do need the antibiotics....

WASSERMAN: ... then we need to take the full dose. Here's the biology of what happens: If there is a bacterial infection in the body, we give antibiotics specific regimen, and if taken as directed, it will kill all of those germs. If we don't take the full course of antibiotics, that means that sometimes people feel better and they just stop taking their medicine, then the germ in the body is only partially wounded if you will, and it can change its structure, and it can come back and resist that antibiotic in the future.

NEMA: Dr. Martin Wasserman, Maryland State Health Commissioner. He says the Association of State and Territorial Health Officials will work with other organizations to let the health provider community know they should resist patient demands for antibiotics, and ask the public to resist asking for them. At risk is the future use of one of our greatest medical tools, antibiotics fighting bacteria. I'm Steve Girard.