ACP-ASIM Executive Speaks on Antibiotic Resistance at National Health Panel
July 27, 2000
Doctors, Patients and Direct to Consumer Advertising Spur Inappropriate Prescribing
WASHINGTON — Popular physician education techniques are not effective in changing physician practice on the issue of antibiotic resistance, said Herbert S. Waxman, MD, senior vice president for education of the American College of Physicians-American Society of Internal Medicine (ACP-ASIM).
Waxman made the remarks at a national workshop, "Antibiotic Resistance: A Serious Public Health Threat," sponsored by the National Health Council, focusing on the problems caused by the misuse of antibiotics.
Waxman said that continuing medical education lectures and unsolicited dissemination of guidelines, even from respected medical sources, have not been effective in changing physician practice. Effective ways to help physicians change practice, he said, include patient-specific reminders or prompts; interactive education programs; personalized visits (educational "detailing") aimed at changing specific behavior; and multiple, reinforcing interventions.
Waxman's appearance is part of the ACP-ASIM's national campaign to reduce antibiotic resistance, a complex problem with the potential to affect millions. The ACP-ASIM initiative includes:
- Expanding content on antibiotic resistance in all education courses the College offers to its 115,000 members each year
- Encouraging and assisting the 74 ACP-ASIM regions and chapters to present continuing medical education courses on antibiotic resistance at their meetings
- Developing clinical practice guidelines for treating diseases prone to over-treatment by antibiotics (sinusitis, bad colds, digestive problems), accompanied by patient education pieces in English and Spanish
- Including research and prevention studies in ACP-ASIM journals, Annals of Internal Medicine and Effective Clinical Practice
- Monitoring federal regulatory and legislative efforts in surveillance, research, and education.
The ACP-ASIM antibiotic resistance initiative is targeted primarily at physicians, because they prescribe antibiotics. However, ACP-ASIM has issued a tip list of activities for adults, hospitals, health systems, governments, pharmaceutical companies and agriculture to help reduce the development and spread of antibiotic-resistant diseases.
Waxman also discussed direct-to-consumer advertising of pharmaceuticals, which encourages patients to ask their physicians for specific antibiotics, usually the newer and more powerful products. These are not always appropriate, Waxman said, and are almost always more expensive than the older, more targeted antibiotics that would work as well. Using powerful, broad spectrum antibiotics for minor infections or no bacterial infection at all (for example for "colds" which are usually caused by viruses) encourages development of resistant bacteria.
The American College of Physicians-American Society of Internal Medicine is the nation's largest specialty society, with more than 115,000 members, including 75,000 physicians active in patient care. ACP-ASIM publishes Annals of Internal Medicine, the most widely cited medical specialty journal in the world.
Susan C. Anderson, 215-351-2653 or 800-523-1546, ext. 2653