Just in time for “Get Smart about Antibiotics Week,” I had a refreshing experience recently, working in a different rural hospital. Over that week, I didn’t see one patient with “superbugs” other than the occasional MRSA. No one had the now scarier Gram negative bugs known as ESBLs (extended spectrum beta lactamases) or the even worse CREs (Carbapenem-resistent enterobacteraciae). I did my part to keep it that way, such as by teaching and modeling use of narrow spectrum, selective antibiotic use. I also have been thinking about the various hospitals I work at, wondering about the local practices that might lead to such vast differences in antibiotic resistance and prescribing patterns.
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