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Antibiotic Resistance Podcast

The U.S. Food and Drug Administration has teamed up with the U.S. Centers for Disease Control and Prevention (CDC) and other health care professional, government, academic, international and industry partners to support Get Smart About Antibiotics Week (Nov. 14-20) as part of a joint effort to encourage the appropriate use of antibiotics. Erica Jefferson from the FDA’s Office of Public Affairs chats with Dr. Edward Cox, director for the Office of Antimicrobial Products talks about this effort, what antibiotic resistance is and why it is so important to wash your hands.


More about Dr. Cox

 Dr. Edward Cox

Edward Cox, M.D., M.P.H. is currently the Director of the Office of Antimicrobial Products, within the Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration. Dr. Cox received his undergraduate degree in chemistry from the University of North Carolina at Chapel Hill in 1985 and his medical degree from the University of North Carolina School of Medicine, Chapel Hill in 1990. Dr. Cox completed his postgraduate medical training in internal medicine at the Hospital of the University of Pennsylvania, Philadelphia in 1993 and in infectious diseases at the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland in 1996. Dr. Cox is Board Certified in Internal Medicine and Infectious Diseases by the American Board of Internal Medicine. Following two years in private practice in infectious diseases, Dr. Cox joined the FDA as a medical officer in the Division of Special Pathogen and Transplant Products in 1998. He subsequently served as a Medical Team Leader before being appointed as Deputy Director of the Office of Drug Evaluation IV in 2003 (which subsequently became the Office of Antimicrobial Drug Products). Dr. Cox was appointed to his current position as Director of the Office of Antimicrobial Products in 2007.


Antibiotic Resistance Podcast Transcript

Erica: Hi, my name is Erica Jefferson and I’m a press officer in the FDA's Office of Public Affairs.

Today we're going to talk about a troubling and increasingly common public health problem, antibiotic resistance.
With cold and flu season right around the corner, we're going to talk about what antibiotic resistance is, when antibiotic drugs should be used and what you can do to help prevent antibiotic resistance.
To talk about antibiotic resistance and a couple of other important issues, we're here with Dr. Edward Cox. Dr. Cox is the Director for the Office of Antimicrobial Products and FDA Center for Drug Evaluation and Research, also known as the Center for Drugs.
Thank you for joining me, Dr. Cox. How are you today?
Dr. Cox: I'm doing fine, Erica. Thanks for having me on today.
Erica: So I know you pretty well from the work we do together at FDA, but let's tell our listeners a little bit about you. How long have you been at FDA and exactly what is an antimicrobial?
Dr. Cox: I've been at FDA for 11 years now and an antimicrobial drug is a drug that's used to treat the infection caused by a microbe. And today we'll be talking about antibacterial drugs and those are drugs that treat bacterial infections.
Erica: So what exactly does your group do here at FDA?
Dr. Cox: So we regulate antibacterial products that are developed for the treatment of infections in humans and we oversee their development from the earliest stages when they go into humans for the first time through the point that an application is submitted that provides information about the drug.
And if the information is satisfactory, it can lead to a new antibacterial drug being marketed, and then we follow the drug after its marketed. During that time period we may learn more about the drug and its safety profile.
Erica: So, Dr. Cox, what is antibiotic resistance and what should we know? Why should I care about this?
Dr. Cox: Antibiotic resistance is when a bacteria becomes resistant to the antibiotic drugs that we use to treat it. So this may mean that an infection doesn't respond to treatment with an antibiotic drug that we're using to treat the infection.
And it's important that we care about antibiotic resistance because it can impact upon our ability to treat infections. So, if a patient has a bacterial infection and they're infected with an organism that's resistant to a particular antibiotic, it may limit the choices of antibacterial drugs that we can use to treat their infection.
And this may lead to a situation where it's more difficult to treat their infection or it takes more time or it may take longer in a hospital before their infection is successfully treated.
Erica: I think have a cold. Should I be taking an antibiotic?
Dr. Cox: Antibiotic drugs don't work against the common cold. The common cold is caused by a viral infection. It's caused by a virus, so antibacterial drugs don't have an effect there. Antibacterial drugs treat bacterial infections. So in the setting of having a cold you shouldn't take an antibiotic drug.
In that setting, the antibiotic drug won't have beneficial effects. It may have side effects. And taking an antibiotic drug for a cold may lead to the development of antimicrobial resistance.
Erica: So what are those - some of those potential side effects that you're referring to if I'm prescribed or a doctor tells me I need to - gives me, I should say, gives me an antibiotic for my viral cold?
Dr. Cox: Well, different antibiotic drugs have different side effects. The types of side effects that can be associated with antibiotic drugs - for some types of antibiotics drugs there can be allergic reactions to the antibiotic drug.
Many antibiotic drugs are associated with gastrointestinal side effects, such as nausea or vomiting or diarrhea. And there's even a more serious type of diarrhea that can occur with antibiotic drugs.
So it's important to be aware of what the side effects are of antibiotic drugs and to only take antibiotic drugs when they're needed for the treatment of a bacterial infection. And your doctor is really the best person to talk with and can prescribe antibiotic drugs when it's appropriate for the treatment of your condition.
Erica: So, what is FDA doing to address the problem of antibiotic resistance?
Dr. Cox: Well, we work with CDC on their Get Smart Campaign. We partner with them on that. We also provide information in our product labeling about appropriate use of antibiotic drugs.
And then we also, in our role as a regulatory agency, work with companies that are interested in developing new antibacterial drugs to provide them with input and guidance throughout the time period that they're developing their drugs.
The goal here is to get new antibacterial drugs to market so that patients and their physicians have additional options to use to treat bacterial infections.
Erica: I've been hearing a little bit about the work that you guys are doing with the Centers for Disease Control and Prevention. Can you tell me a little bit about what exactly Get Smart about Antibiotics Week is?
Dr. Cox: Get Smart about Antibiotics Week is our annual opportunity to remind folks about the importance of using antibiotic drugs appropriately. The CDC has a Get Smart Campaign that goes on a year long that we partner with them on.
And this is the week that we, once again, reach out to folks to remind them about the importance of using antibiotic drugs appropriately so that we continue to have them available and to use them to treat infections where they provide important benefits to patients.
Erica: So, we've talked about when an antibiotic probably shouldn't be prescribed, so for something like, you know, a common cold, which is more of a virus, but when should we be prescribing antibiotics?
Dr. Cox: So always talk with your doctor about illnesses that you have that you think may be more severe or need medical attention. And your doctor can prescribe antibiotic drugs for treatment of bacterial infections, such as infections of the skin, we often times call this cellulitis, pneumonia or an infection in the lung, infections in the urinary tract also receive antibiotic treatment.
So there are a number of bacterial infections that antibiotic drugs are used for where antibiotic drugs provide important benefits to patients in treating their condition.
Erica: Are there any keys to success for combating antibiotic resistance?
Dr. Cox: Well, it's important that we use the antibiotic drugs that we have prudently. That is, is that we use them for treatment of bacterial infections and that we don't use them in the setting of viral infections where they don't any effect. And this will help to preserve the utility of the antibiotic drugs that we rely upon.
And then there are also other things that folks can do to try and reduce the chance of infections, simple things such as washing your hands can help to prevent transmission of infections.
And in addition at this point in the year, it's also important for folks to remember to get their annual flu shot. That's another way to try and prevent influenza infection and that's - is important because it can eliminate one of the common causes of infection that people experience that can be confused with a bacterial illness.
Erica: So what are some tips that we should takeaway from the discussion we just had? What does FDA recommend that consumers do?
Dr. Cox: It's important to remember that antibiotic drugs don't work against viral infections, such as the cold or the flu. It's important when your doctor prescribes an antibiotic drug that you take your medicine as it's been prescribed to you. Folks should not save antibiotics either. It's meant for use during a particular infection that it's prescribed for.
And it's important, too, not to take antibiotic drugs that are prescribed for others. If you have a particular illness and the antibiotic drug was prescribed for somebody else, it may not be the correct drug for your condition. So you should always talk with your doctor about the diagnosis and treatment of your infection.
Erica: Dr. Cox, thank you for joining me today. I know a lot more about antibiotic resistance than I did before. As you mentioned earlier, November 15th through the 21st is Get Smart about Antibiotics Week.
So with that said, I'm Erica Jefferson from the FDA’s Office of Public Affairs and remember everyone, wash your hands.