Antibiotics

Biography

Biography: Douglas Burgoyne

Abstract

Antibiotic resistance (AMR) is a major global health concern according to WHO, CDC, and governments worldwide. Resistant infections kill 23,000 Americans annually. Upper respiratory tract infections (URTIs) are mostly viral (60%-90% non-bacterial) and self-limiting, yet inappropriate antibiotic prescription is common, especially in primary care, which drives AMR. Even for bacterial URTIs antibiotics offer little or no immediate benefit; patients still need symptomatic therapy, which should always be utilized to minimize inappropriate use of antibiotics. The Global Respiratory Infection Partnership (GRIP) was initiated in 2011 to promote rational antibiotic stewardship for URTIs by focusing on symptomatic therapies and reducing inappropriate antibiotic use. The organization has developed the ‘5P’ framework to promote change and appropriate management of URTIs. Most antibiotics are low-cost drugs and provide little financial incentive for improving rational prescribing, compared to the expense of biologics and other novel drugs. However, there is an overwhelming public health imperative for reducing antibiotic resistance and promoting responsible antibiotic stewardship. What can be done? Strategies are required that increase access to symptomatic therapies and incentivize their use, including over-the-counter products. Different reimbursement approaches could also be considered. Ways to achieve these goals will be discussed, including potential roles for primary care and pharmacies. Managed Care can also influence patient education, especially concerning misperceptions about antibiotic use. Conclusions Managed Care could potentially reduce inappropriate antibiotic prescribing and increase use of symptomatic therapies to reduce AMR. This would support the goals of GRIP for responsible antibiotic stewardship and promotion of symptomatic therapies for URTIs.