These numbers were unheard of a generation ago. Antibiotics were considered harmless by doctors, and have few side effects. Over the past two decades, the number of antibiotic-resistant infections has risen dramatically in the United States. Health professionals who have tried to reduce their use have also been resistant. This has been going on for many years. It has been a constant struggle for me over the 25 years that I have been practicing medicine. “It’s becoming more prominent because it’s getting worse,” stated Dr. Mark Horne who is vice chair of the board for trustees of the Mississippi State Medical Association. Antibiotics have revolutionized medicine since their introduction in 1920s. They made once-deadly infections manageable. According to the CDC, only 30% of antibiotics prescribed in emergency rooms and clinics in the United States are necessary. Lauri Hicks is a medical epidemiologist at the CDC. She said, “Changing behavior can be difficult and it requires a shift in culture regarding how we use antibiotics.” Misuse of antibiotics has resulted in antibiotic resistance, which is a growing threat to public health. The CDC estimates that over 2 million people are infected annually with resistant organisms, resulting in around 23,000 deaths. Hicks stated that “we cannot wait to take action because we are already in a situation where we see infections where there is very little or no treatment options.” “Infections have been a problem for many decades in patients admitted to hospitals with a variety of medical conditions. We are now seeing a lot of antibiotic resistant infections in otherwise healthy individuals in the community. That’s very concerning. It’s having an effect on everyone.” The national number of antibiotic prescriptions has dropped about 5 percent since 2011, from 877 per 1,000 people in 2011 down to 835 in 2014. The two states with the highest numbers of antibiotic prescriptions are West Virginia and Kentucky. Their numbers dropped from 1,355 and 1,285 to 1,321 and 1,262, respectively between 2011 and 2014. The most concerning thing about Mississippi’s numbers is their increase of nearly 4 percent from 2011, when they were 1,186 prescriptions, to 1,222 in 2014. Hicks stated that there is a lot of geographic variability in antibiotic prescribing. The South, especially the Appalachian region through Louisiana and Mississippi, has higher rates and (Mississippi), has rates that are twice the amount. In Washington State, 600 prescriptions were written for antibiotics per 1,000 residents in 2014. Oregon had 570 prescriptions. Hicks and Horne stated that it was difficult to determine why Mississippi has struggled to reduce antibiotic use. Horne suggested that Mississippi may be lacking doctors. Mississippi has the lowest number of doctors per 100,000 residents, making it the most difficult state to find a doctor. It is plausible to assume that because of the shortage of doctors, providers will have to see more patients and spend less time. Horne stated that a prescription for antibiotics is usually quick and simple and addresses the immediate problem. Hicks stated that although the CDC hasn’t shown a link between a lower number of doctors and a greater supply of antibiotics, it has been able show that this is closely tied to areas with lower incomes where there are often shortages. Hicks also suggested that Mississippians may require more antibiotics than usual due to chronic conditions. Hicks stated that when we look at maps for chronic conditions like obesity, we see that they are very similar. This could indicate that there may be health disparities that can contribute to the state’s health. It’s likely a complicated answer. Horne stated that several Mississippi hospitals have antibiotic stewardship programmes, which advocate for responsible antibiotic use. However, Mississippi does not have legislation mandating such programs. Horne also said that the Mississippi State Medical Association is committed to reducing overuse of antibiotics. In 2015, only 24 percent of Mississippi hospitals had an anti-biotic stewardship program. This ranks it third in the country. In 2015, the national average was 48%. Over the past few years, West Virginia and Kentucky have both implemented state-funded programs to reduce antibiotic overuse. Hicks stated that these programs “may have an impact.” In 2017, the President’s Council of Advisors on Science and Technology recommended a regulatory requirement regarding antibiotic stewardship. This report was released in conjunction with President Obama’s executive order calling for regulations that require antibiotic stewardship programs. Hicks stated that the goal was for all hospitals to have stewardship programs that are in line with the core elements published. Hicks stressed the importance of reducing the use of antibiotics in Mississippi and across the country. Hicks stated that these drugs are valuable resources and must be kept in reserve for when they are needed. To support this important work, you can make a regular donation to the Spring Member Drive today. Our reporters give a human face to policy’s impact on everyday Mississippians by listening more closely and understanding their communities. To ensure that our work is aligned with the priorities and needs of all Mississippians, we are listening to you. Click the button below to let us know what you think.