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The Epidemic of Overuse: Antibiotics

Sherrill Butler-Williamson

Delaware Technical Community College

NUR 420- Policy

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The epidemic of overuse in antibiotic administration has negatively impacted our

healthcare systems. Antibiotic were created in 1928 by Alexander Fleming to combat bacterial

infections. Antibiotics are life-saving drugs, and if they are overused or used inappropriately

they will become powerless against life-threatening infection. Losing the effectiveness of

antibiotics would undermine its ability to treat patients with deadly infections, it would decrease

the ability to help cancer patients, to provide necessary organ transplants, and to prevent surgical

site infections. The overuse of antibiotics in human and animals cause antibodies to develop and

the body becomes resistant to the antibiotic (Antibiotic prescribing and use, 2018).

Antibiotic resistances are one of the largest threats to healthcare and food security in the

United States. Antibiotic resistance can affect anyone, of any age, in any country. Antibiotic

resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the

process. There is a tremendous increase in the incidence of infections such as pneumonia,

tuberculosis, gonorrhea, and salmonellosis. These infections have become difficult to treat

because the antibiotics used to treat them have become less effective (Antibiotic resistance,

2017). According to the Center for Disease Control and Prevention (CDC), in the United States

alone each year at least 2 million people acquire very serious bacterial infections that are

resistant to one or more of the antibiotics. These antibiotic-resistant infections cause over 23,000

deaths every year in the United States (Antibiotic prescribing and use, 2018). According to the

Delaware Healthcare-Association Summary Report of 2015, the State of Delaware had a 52%

increase of antibiotic- resistance infections than projected, which is 15% greater than the national
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average (Delaware healthcare-associated infection annual report 2015, 2016). According to

research, the over-prescribing of antibiotics in outpatient facilities nationally resulted in 13% of

all visit were given antibiotics and of that 13%, 50% were given unnecessarily for upper

respiratory infections. On the same token, 33% of inpatients were given antibiotic unnecessarily

or longer than needed which eliminated the normal flora in the gut. This led to an increase in

patients with hospital-acquired Clostridium Difficile (C-Diff), killing about 14,000 patients each

year (Jerusalmi, D., 2016).

The rising cost of healthcare is a national issue. The cost of healthcare is projected to

grow 5.5% each year from 2017-2026. It will reach 5.7 trillion dollars by 2026. The exponential

cost will be greater than the Gross Domestic Product (GDP) by 1% each year. The cost of

healthcare to taxpayers is growing faster than inflation (National health accounts projected,

2018). According to the National Health Accounts Project to the Center of Medicare and

Medicaid Services (CMS), the cost of healthcare for each program will increase by 6.5% in the

next three years, by 2021. Delaware currently spends 8.3 million dollars on healthcare, it will be

an increase of 600,000 per year for taxpayers.

The epidemic of overuse with prescribe antibiotics has contributed to the increasing cost

of healthcare. With an excess of prescribed antibiotics, individuals have a longer recovery period

which increase hospital length of stay. There is an additional to patients, and insurance

companies for treatment of antibiotic resistant bacteria in patients. For patients that are treated

for antibiotic resistant infections, the financial cost can average between 24,000-31,000 per

incident (Jerusalmi, D., 2016). The cost of overuse, or misuse of antibiotics is not just financial,

it is life-threatening and life-changing. People are at risk for other health complication, for

instance; issues with tendons, joint, nerves, and issues with the Central Nervous System (CNS).
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Some people have an increased risk of an Aortic Aneurysm or an Aortic Dissection which

changes a person’s quality of life (Jerusalmi, D., 2016).

The overuse of antibiotics is a local, state and federal issue where major change needs to

occur. Currently, Kent County Delaware do not have local legislation that address the epidemic

of overuse and abuse with antibiotics. Kent County adheres to the legislation and policies of the

State of Delaware. there are local stakeholders that I can address to bring fourth this issue to the

forefront of elective officials. Locally, I would address the City Council of Dover and speak

specifically with Sara J. Herbert. Sara is the At-Large member of the Dover Human Relations

Commission. Sara J. Herbert displays her passion for patient advocacy by speaking aloud for

patients needs in Maryland. Sara J. Herbert has organized and implanted groups that spoke to

legislators to get healthcare policy implemented. She is a nurse that advocates for her patients

(Herbert, S., n.d.). There is healthcare legislation that addresses the overuse of antibiotic for the

State of Delaware. The Delaware Healthcare-Associated-Infection (HAI) Antibiotic Stewardship

Program is a public healthcare policy that models the National Action Plan for Combating

Antibiotic Resistant Bacteria. Antibiotic Stewardship Program was developed and implemented

to improve the use of antimicrobial drugs with the goal of improving patient health outcomes,

reducing antibiotic resistance and decreasing unnecessary costs of healthcare through leadership,

accountability, reporting, education, drug-expertise, and implementation (Delaware healthcare-

associated infection annual report 2015, 2016). Kelly Gardner, the Chair of the Delaware

Healthcare Association Infection Advisory Committee, is the key stakeholder that I would

address on the state level. Kelly understands the importance of eradicating the epidemic of

overuse of antibiotics. Kelly Gardner is a nurse at Bayhealth Medical Center. She understands

the impact on healthcare and patients. Kelly is aware of the cost to the patients and organizations
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when patients acquire a HAI. She has the ability and the platform to facilitate a conversation

with legislators (Delaware healthcare-associated infection annual report 2015, 2016). On the

national level, there are several policies regarding antibiotic resistance. The National Strategy

Policy is a proposal for the United States with domestic and global partners to reduce the

national and global threats of antimicrobial resistance. The goals of this policy are to decrease

development of resistant bacteria and eradicate the spread of resistant infections, to make the

One Health data collection more useful, to make innovations and advancement in rapidly

identification of resistant strains of bacteria, and increase and improve prevention, control, data

reporting and research to elimination resistance to antibiotics (Antibiotic / antimicrobial

resistance, 2018). Senator Thomas Craper, my elected official, is the key stakeholder that I

would contact my written proposal. Senator Thomas Craper sits on the Healthcare

Subcommittee. The Healthcare Subcommittee is where federal healthcare legislation is sent for

review (Senate committee on finance: subcommittee on health care, n.d.)

With the current policies and laws in place to combat the epidemic of overuse with

antibiotics, there is still an increase in the number of people acquiring antimicrobial resistances.

To advocate for patient safety and health promotion I would being lobby for implementation of

antibiotic drug administration education and regulations. I would begin the process by making

people in my current circle aware of the epidemic healthcare is facing with the overuse of

antibiotics. I would form a task of nurses who are passionate about the cause, research current

policies and begin writing the necessary changes to propose. The taskforce and I will send letters

to our local elective official displaying the evidence. We will make appointments to meet with

local officials to lobby for healthcare policy implementation. I will also contact the American
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Nursing Association (ANA) to get the issue heard on a national platform. When addressing

policy makers, I will propose the necessity and implementation of advance education programs

for healthcare providers, patients, and farmers on the administration of antibiotics for humans

and animals to reduce the epidemic of overuse with antimicrobial medications. Education for

healthcare providers on the safe and effective use of antibiotics needs to be in person, continual,

and healthcare providers should have ample time allotted for the education. There is a need for

national administration guidelines for adults and children. A national tracking program for

antibiotic distribution should be mandatory for all states. This permits a continuity of care and all

providers will be able to collaborate for safe patient outcomes. There is a drastic call for

implementation of patient education programs that consist of the dangers of antibiotic overuse,

when and why they should be taken, and the appropriate way to take antibiotics. This education

will help patients understand the safe use of antibiotics and help to eliminate patients request for

antibiotics, while decreasing the incidence of antibiotic resistance, and also simultaneously

reducing the cost of healthcare (National health accounts projected, 2018). The agricultural

population requires education and regulations that eliminates the use of antibiotics

prophylactically in livestock that is ingested by humans. The overuse of antibiotics in farming

for mass production of food also has aided in the development of antibiotic-resistant superbugs

(Antibiotic / antimicrobial resistance, 2018).

My purpose for speaking with elected officials is to advocate for change on behalf

of safety for all human beings. My goal is to make people more aware of the dangers, risk and

the cost of the epidemic of overuse with antibiotics. This epidemic is not just an issue for this

generation, if we do not act today it will destroy future generations. They will not have the

means to sustain or defeat life-threatening disease. Within the next 90 days, I plan to start
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educating my peers on the epidemic of overuse with antibiotics in the United State and how we

as nurses can help educate patients, family, and friends.

In conclusion, there is an epidemic of overuse of antibiotics which results in

antimicrobial resistance to life-saving medications. With this action plan, I hope to accomplish

the implementation of policies that consist of education for healthcare providers, patients, and

farmers that will display a change in the dispensing and use of antibiotics. I believe that with

knowledge there will be a decrease in the amount of antibiotics that are unnecessarily prescribe

to humans and animals. Knowledge is power. Let’s eradicate this epidemic before it becomes a

pandemic.
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References

Antibiotic resistance. (2017). Retrieved from http://www.who.int/news-room/fact-

sheets/detail/antibiotic-resistance

Antibiotics prescribing and use. (2018). Retrieved from http://www.cdc.gov/antibiotic-

use/stewardship-report/

Antibiotic/antimicrobial resistance (AR/ AMR). (2018). Retrieved from

https://www.cdc..gov/drugresistance/us-activities/national-strategy.html

Delaware healthcare-associated infection annual report 2015. (2016). Retrieved from

https://www.dhss.delaware.gov/dhss/dph/

Herbert, S. J. (n.d.). Sara j. herbert bio. Retrieved from https://www.cms.gov/Research-Statistics-

Data-and-Systems/Statistics-Trends-and

Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html

Jerusalmi, D. (2016). Study reports overuse of antibiotics within the united states. Retrieved

from https://www. recallcenter.com/study-reports-overuse-of-antibiotics-within-the-us

National health account projected. (2018). Retrieved from https://www.cms.gov/Research-

Statistics-Data-and-Systems/Statistics-Trends-and

Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html

Senate committee on finance: Subcommittee on health are. (n.d.). Retrieved from

https://www.govtrack.us/congress/committees/SSFI/10#activity