Nhung's policy paper

Policy on Unnecessary Antibiotics Prescriptions Should Be Initiated

Health care has always been an important topic. Every day, there are always chances of people getting sick. In America, the misuse of antibiotics has become a problem. Studies have shown that the causes of misuse of antibiotics are mainly because of patient demand for antibiotics and because of large numbers of unnecessary prescriptions from doctors to patients (1). Many patients tend to expect that they will get a prescription whenever they visit a doctor. Patients’ demand for antibiotics pressures the doctors to prescribe even when they know that the prescription is unnecessary for patients. Doctors claim that 21% of the prescriptions they prescribe can be considered as unnecessary, and the reason that they prescribe those prescriptions is because they want to please the patient (3). Another study about sore throat prescriptions showed that a sore throat does not require an antibiotic; however, the number of prescriptions for sore throat is quite high: “General practitioners estimated they prescribed antibiotics for fewer than 1 in 10 to a maximum of half of patients consulting with sore throat” (5).

The problem with giving out unnecessary prescriptions is it could result in wasting antibiotics and could lead to antibiotic resistance. Antibiotic resistance occurs when bacteria become resistant to the antibiotic, making the bacteria harder to kill. As a result, a stronger antibiotic must be developed in order to destroy that bacterium. However, the problem is it takes a long time for a new antibiotic to be developed. Since “only one new class of antibiotic has been introduced in the past 40 years” (2), it is important for health care providers and patients to understand the important use of antibiotics, and try to not waste them by reducing the number of unnecessary prescriptions. In addition, many studies have shown that the best way to decrease the problem with antibiotic resistance is to reduce the amount of antibiotic treatment in humans (4).
Mercy, one of the major hospitals in Sioux City, would like to solve the problem above by setting the policy below. This policy is one way to eliminate the use of unnecessary prescriptions and to solve the problem of antibiotic resistance.
I. POLICY
A. Health care providers at Mercy will not be allowed to prescribe any antibiotics that are demanded by the patient when they know that the antibiotic is unnecessary for the patient. This restriction will help cut down the waste of antibiotics. It also lets patients know that they cannot demand antibiotics based on personal desire.

B. Mercy’s doctors are responsible for discussing with patients the medication and reminding them to follow directions of the drug before handing them the hard-copy prescription. Since patients do not have much knowledge about antibiotics, they tend to assume that their health will become better by just taking many antibiotics all at once. It is important for the doctor to alert them that the medication will not work well if they do not use it correctly.
Starting in January of 2009, Mercy Hospital will record all the antibiotics that are prescribed by Mercy’s physicians. In order to do this, Mercy will hire three people from the FDA to observe and record the conversation between physician-patient to determine whether the physician has violated the policy. Mercy will also be responsible for funding the three members of FDA. Physicians who violate the policy above will have a 15 % reduction from a one-month paycheck and will have to attend one-week-long lessons learning about antibiotic resistance.

Antibiotic resistance is important for society because it is the best way to control the resistance of bacteria and protect human health. Patients tend to demand antibiotics that are not necessary for their treatment. Many doctors agree to prescribe those antibiotics to patients anyway to please them. However, that behavior could result in shortages of antibiotics and strengthen the growth of bacteria. Mercy is responsible for sponsoring this new policy to restrict the usage antibiotic at Mercy Hospital. In addition, the policy above should be enforced to eliminate the misuse of antibiotics in healthcare.

References
1. Vanden, Jodi. “Consumer Attitudes and Use of Antibiotics.” Emerging Infectious Diseases Vol. 9, No.9 (2003): 1128-1135.
2. Hall, Barry. “Predicting the evolution of antibiotic resistance genes.” Perspectives Vol.2 (2004): 430-435.
3. Greenhalgh, Trisha. “Pressure to prescribe.” BMJ.com. 6 December 1997 < http://www.bmj.com/archive/7121/7121e4.htm>.
4. Cohen, Robert. “Approaches to Reduce Antibiotic Resistance in the Community.”Pediatric Infectious Disease Journal (2006): 977-980.
5. Satinder, Kumar. “Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study.” MBJ.com (2003).

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