Why Antibiotics are Not the Answer to Everything: Urgent Cares and the Rise of Antibiotic Resistance

Illustrated by Elena Bosak

Many people go to an urgent care center when experiencing a relatively minor health issue. Flu tests and strep cultures yield the same results no matter where they are administered, so many people, including college students, opt to go to a more convenient place where the wait time will be shorter. Those who enter an urgent care center often do not leave empty-handed; they are given a prescription to fill. Urgent care centers get extremely busy when an illness like the flu is going around; this means doctors must see large numbers of patients in a short period of time. In order to satisfy the patient, a doctor will frequently prescribe an antibiotic, as the core mission of urgent care “is to ‘give patients what they want when they want it’.” While it may be well-intentioned, this practice of handing out pills with abandon led to a problem: antibiotic resistance.

Antibiotic resistance is becoming increasingly problematic throughout the world and is now a major health concern in the United States. A recent study uncovered that close to 3 million US citizens experience an infection due to antibiotic resistance each year (3). Antibiotic-resistant bacteria, or “superbugs,” “cause 35,000 deaths per year in the country.” Superbugs are more deadly than regular bacteria because there are fewer means to eradicate them. The antibiotics that are typically used are no longer efficacious once someone has built up resistance to the medication. When an individual has a bacterial infection and the bacteria are superbugs, he or she faces higher health risks and often experiences poorer expected health outcomes (3).

Antibiotic resistance occurs when antibiotics are overused. An antibiotic should only be taken for bacterial infections, yet many individuals take them for viruses and other maladies (3). As a result, “good” bacteria in the body are killed off, threatening the delicate balance between helpful and harmful bacteria in the human body. When an individual unnecessarily takes an antibiotic, antibiotic-resistant bacteria can take over more easily, which increases the number of strains of these so-called superbugs (3). According to the World Health Organization (WHO), antibiotic resistance is currently “one of the biggest threats to global health, food security, and development today.” (3) It is important to note that while antibiotic resistance occurs naturally, the overuse of antibiotics accelerates this process, thus increasing the magnitude of the problem.

As mentioned, urgent care centers exacerbate the issue of antibiotic resistance by writing unnecessary prescriptions in order to satisfy their patients. A study conducted by the CDC analyzed 2014 data and found that “among patients who visited urgent care centers for antibiotic-inappropriate respiratory problems like bronchitis, flu or asthma, nearly half (45.7%) were incorrectly prescribed antibiotics.” Alarmingly, when a patient expresses interest in being prescribed an antibiotic, a doctor is more likely to prescribe it; it is unsurprising, then, that 39 percent of urgent care visits end with an antibiotic prescription, even though far less should (5). Pressure to satisfy a patient’s desires may seem innocent, but most patients are not trained the way their providers are, and to have such power over the treatment plan is dangerous.

Not much, if anything, can be done to combat superbugs once they develop; instead, efforts need to be made to prevent the creation of the superbugs in the first place. The WHO has issued statements saying that antibiotics cannot be shared, taken unnecessarily, or disposed of carelessly (1). The WHO has also mentioned that whenever an antibiotic-resistant infection is seen, it should be reported in order to prevent other individuals from contracting it (1). Antibiotic stewardship interventions are needed to prevent superbugs. “Antibiotic stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.” By increasing physician awareness of the appropriate time to prescribe an antibiotic, drug efficacy and patient safety will increase.The Urgent Care Association (UCA), has begun to make efforts to combat the antibiotic resistance crisis. The group has teamed up with the Antibiotic Resistance Action Center (ARAC) “to better understand challenges and opportunities within the urgent care delivery system.” Together, the groups authored a Commitment to Antibiotic Stewardship, in order to “improve antibiotic stewardship among medical providers and to educate patients.” This recent commitment to antibiotic stewardship will hopefully bring changes to the way urgent care centers prescribe antibiotics, and will in turn help prevent future superbugs from forming.

Edited by: Casey Connelly
Illustrated by: Elena Bosak

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