If we want to cut down on antibacterial resistance, we should certainly stop buying that stupid hand soap, but we should also stop doing symptom-based medicine when it comes to sexually-transmitted diseases (STDs), which the regular medical community abandoned years ago.
Leave that kind of 'act first, think later' approach to homeopaths, naturopaths and chiropractors.
If we did, 75 percent of emergency department patients with symptoms of gonorrhea or chlamydia would not just be handed antibiotics only to test negative.
Researchers from St. John Hospital&Medical Center in Detroit, Michigan, examined records of more than 1,103 patients who underwent STD testing in the emergency departments to identify the extent of unnecessary antibiotic use. Genital cultures are commonly collected from patients with signs and symptoms of STDs; however, results are not immediately available, and antibiotics are often prescribed without a confirmatory diagnosis.
Of the 1,103 patients tested, 40 percent were treated with antibiotics for gonorrhea and/or chlamydia; of those treated, 76.6 percent ultimately tested negative for having the STD. Of the 60 percent who went untreated, only 7 percent ultimately tested positive for either or both STDs.
"We have to find the appropriate balance between getting people tested and treated for STDs, but not prescribing antibiotics to patients who don't need them," said Karen Jones, MPH, BSN, RN, infection preventionist, St. John Hospital&Medical Center. "There is a tricky balance between not furthering antibiotic resistance by over-prescribing, but also still getting people treatment for STDs they might have."
The study also examined how certain symptoms were associated with positive STD cultures. For example, in male patients, 60.3 percent with penile discharge and 57.5 percent with inflammation of the urethra tested positive for gonorrhea and/or chlamydia. In female patients, 25 percent with inflammation of the cervix and 27 percent with cervical motion tenderness tested positive for gonorrhea and/or chlamydia. Thirty-five percent of patients who disclosed they had more than one sex partner also tested positive for gonorrhea and/or chlamydia. "Focusing on these clinical predictors may improve unnecessary antibiotic prescribing in patients without true disease," said Jones.
Presented at the 43rd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).