Who would have ever thought when I was in medical school that I would be touting my pediatric colleagues’ reduction in the use of antibiotics–one of the greatest medical discoveries of all time–as a major accomplishment. I remember to this day the lecture in med school when the Professor of Pharmacology described how the pioneers of antibiotics felt that they had discovered the “Silver Bullet”: the cure for all infectious diseases. But alas, like all great technological advances, they come with limitations and problems. The past 25 years, doctors have developed a new found respect for the amazing little creatures we call bacteria, viruses, parasites, and fungi. Nimble is an understatement for how amazingly fast these creatures can adapt to all sorts of medications meant to halt their growth. The more doctors use antimicrobial drugs, the faster they become irrelevant.
This brings us to the subject of children and drug use. Children are big consumers of antibiotics, because infectious diseases are their main source of illness. Experts have been very anxious to find safe ways for pediatricians and family doctors to use fewer antibiotics, especially in children. In the July 2012 issue of Pediatrics, epidemiologists at the FDA reviewed data on the use of antibiotics as well as other medication classes in children during the period from 2002-2010. Here is the breakdown:
Antibiotic usage down 14% Asthma medication usage up 14%
Allergy medication usage down 61% ADHD medication usage up 46%
Pain medication usage down 14% Contraception usage up 93%
Depression medication usage down 5%
Cough/Cold medication usage down 42%
The conclusions that I draw from this data are that pediatricians continue to make progress in the judicious use of antibiotics. This is great news for everyone. Hopefully keeping our antibiotic “powder dry” will make these medications more effective in the future, especially for children with serious infectious diseases. As for the rest of this data, that is a subject for another memo or two.
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