Chances are you’re not a doctor nor play one on TV.

That’s why health care professionals are becoming increasingly concerned about patients who go to doctors’ offices certain they need the latest antibiotic to cure everything from pimples to earaches.

The state’s top health official is pointing to a medical mystery that has gripped parts of the eastern United States as a reason why the public may want to re-examine its fascination with antibiotics. Recent articles in respected medical journals have suggested that a specific intestinal infection has begun to mutate and become more difficult to treat because of an overexposure to antibiotics.

“I don’t think there is any question that we have seen the overuse of antibiotics in this country, and that can cause some problems,” said Dr. Howard Rodenberg, director of health for the Kansas Department of Health and Environment. “I think what we need to do now is recognize that antibiotics are useful for a whole lot of things, but not useful for everything. I think a lot of people think they are a cure-all when they’re not.”

Controlling C. diff

The medical mystery that has re-ignited the debate over antibiotic use deals with a bacteria called Clostridium difficile, also known as C. diff. The intestinal infection can cause painful stomach cramps, nausea and severe diarrhea that can lead to dangerous dehydration.

But C. diff for years has been largely under control by the medical community. For one thing, it usually only showed up in patients who had received powerful antibiotics as part of a stay in a hospital. But when people contracted the infection, it typically could be treated fairly easily with a combination of medications.

Lawrence Memorial Hospital pharmacist Becky Rutledge, foreground, and Heather Smith, a certified pharmacy technician, sort medication, including antibiotics. An overexposure to antibiotics may be contributing to the spread of an intestinal infection in the eastern U.S.

New studies published in the New England Journal of Medicine and a related federal medical journal have found that the bacteria is increasingly turning up in people who haven’t been in the hospital. There also are reports that traditional medication is becoming less effective in treating the infection, making it more deadly to patients. The infection has been blamed for 100 deaths in an 18-month period at a hospital in Quebec, Canada.

Rodenberg said he didn’t have evidence C. diff was becoming more prevalent in Kansas. But he said it was worth keeping an eye on because of its connections to antibiotic use.

The study in the New England Journal of Medicine took bacterium samples from eight hospitals in six states – Georgia, Illinois, Maine, New Jersey, Oregon and Pennsylvania – that showed the bacteria was mutating to become even more resistant to antibiotics.

Some studies also have suggested people on powerful heartburn medication such as Nexium and Zantac may be at greater risk for the infection, though questions remain about those findings.

“I don’t want to scare people away from using antibiotics : but it is concerning and we need to respond,” said Dr. L. Clifford McDonald, an epidemiologist at the federal Centers for Disease Control and Prevention.

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Rodenberg said average consumers could play a role in helping ensure antibiotics didn’t become so overused that the laws of evolution made them useless.

“I think a wonderful take-home message from this issue would be to ask your doctor whether you really need an antibiotic instead of going in with the attitude that you know you need one,” Rodenberg said.

Sickbed viewpoint

Patrick Parker, director of pharmacy and IV therapy at Lawrence Memorial Hospital, said he agreed that patients probably have come to expect antibiotics too often. But he also said it was hard to blame patients. After all, if your ear hurts, you want the best medicine to make it stop hurting.

“I think saying you’ll tough it out or use a lesser medicine is easy to do from the standpoint of the armchair but hard to do from the standpoint of a sickbed,” Parker said. “I say that very sincerely. I know it is tough for me to do.”

Rodenberg said it also is tough to blame doctors for frequently prescribing antibiotics, even though they control the prescription pad. Rodenberg said it was important for doctors to meet their patients’ expectations.

“There is a reason that they say medicine is a science and an art,” Rodenberg said. “Part of practicing good medicine is gaining a patient’s trust so you can intervene when you really need to intervene. I think oftentimes doctors are stuck between a rock and a hard place.”

Parker agreed. He said doctors often struggled with providing the most relief to a patient while understanding that an overuse of antibiotics ultimately will reduce the effectiveness of all antibiotics.

“Antibiotics have been tremendously beneficial,” Parker said. “We’re living in the antibiotic era. The question is, how long will it last?”