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OHSU Creates National Model for Antibotic Use

   Portland, Ore.

The next time you see your physician for your child's ear infection or for your own sore throat and stuffy nose, you'll more than likely leave the office with great advice, a few over-the-counter medications, but no antibiotics.

The overuse and misuse of antibiotics has LONG been a national public health care problem. These practices have led to increasing bacterial resistance to antibiotics and the development of "superbugs." But thanks to a two-year $226,000 national grant, Elizabeth Steiner, M.D., assistant professor of family medicine, Oregon Health & Science University School of Medicine, and her team will create a national model to teach primary care physicians-in-training appropriate antibiotic use.

"More than 60 percent of antibiotics prescribed in the United States are for the five most common upper respiratory infections, but at least half of those prescriptions are unnecessary. We have a unique opportunity to teach frontline physicians how to use these potent medications appropriately. This will improve patient care by reducing the risk of antibiotic resistance and of patient side effects related to antibiotic use," Steiner said.

This project is funded by the Centers for Disease Control and Prevention through the Association of American Medical Colleges.

The intent is to take curriculum that was developed at the University of California, San Diego, and modify it to be sure it's completely based on the most current evidence and is taught in a way that works for medical residents, rather than students. This information will be part of the OHSU family medicine residency curriculum beginning fall 2004. It will be expanded to internal medicine and pediatric residencies across Oregon for the next school year. After that, the Centers for Disease Control and Prevention will make the OHSU model available nationwide.

Steiner's team includes: L.J. Fagnanv, M.D., associate professor of family medicine; Thomas Ward M.D., associate professor of medicine (infectious diseases); Ann Thomas M.D., M.P.H., clinical assistant professor of public health and preventive medicine, and medical director of Oregon Alliance Working on Antibiotic Resistance Education; and Paul Lewis, M.D., M.P.H., adjunct professor of pediatrics, and public health officer in the Oregon Department of Human Services Acute and Communicable Diseases. All are from the OHSU School of Medicine.

An estimated seven out of 10 Americans receive antibiotics unnecessarily when they seek treatment for a common cold, and only one-third of patients use antibiotics the way doctors tell them. When an antibiotic is overused or misused, bacteria can become resistant to the antibiotic so that the medication cannot kill the bacteria or keep it from growing. Some bacteria that cause common infections have become resistant to many different antibiotics. For example, Streptococcus Pneumoniae, a bacterium that often causes lung infections, is no longer easily treated with antibiotics such as penicillin. This means that diseases that were once easily cured with basic antibiotics now often require hospitalization and use of more specialized medications.

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