Dr Doug Burgoyne (USA)

Dr Burgoyne explained how the CDC increased funding for AMR for two years in a row. In 2016 $160 million was dedicated to AMR, $163 million in 2017, and there are hopes this trend will continue into 2018.

The majority of this funding is distributed to individual states to run their own AMR campaigns such as educational programs for school children and billboard advertisements. In addition, there are regular articles in national newspapers such as the Wall Street Journal and the New York Times, talking about resistance and the need to appropriately use antibiotics.

The news reports are warning everybody, including consumers,
but physicians are still caving to their patients and giving them the antibiotic when they ask for it

Dr Doug Burgoyne

Despite these initiatives, there is still a significant amount of pressure on physicians to prescribe antibiotics. Some of this pressure comes from the need to generate high patient satisfaction scores in order to receive maximum reimbursement from health plans and achieve bonus. Not only do consultations take longer when explaining the reasons for not prescribing an antibiotic but also often the patient leaves dissatisfied. This provides an incentive to capitulate to patient demands even if this means overprescribing antibiotics.

Dr Burgoyne explained that from a pharmacist perspective in the US there isn’t a great deal of time spent educating patients about appropriate use of antibiotics. This is likely because pharmacies are extremely busy, often filling 600-700 prescriptions per day. Therefore, if a prescription comes in for an antibiotic, it often gets filled with no discussion nor comment from the pharmacist.

Dr Burgoyne concluded that this may be a learning that the US could take from the GRIP initiative and re-engage with pharmacists to educate them about the impact that inappropriate antibiotic use has on AMR.