Dr Bird's note: I often search the news for information on Methicillin Resistant Staph Aureus (MRSA), an emerging super bug I often see at the urgent care center I work at. This letter, published in the Louisville Courier-Journal, is in response to a story about a MRSA outbreak at a local prison.

Saturday September 24, 2005 Louisville Courier-Journal

'Inappropriate' use of broad-spectrum antibiotics
Your recent report on the outbreak of staph among prison guards came as no surprise. As a family physician at a local urgent care center, this summer -- for the first time ever -- I've seen a "rash" of patients with this nasty staphylococcus "super bug," otherwise known as community-acquired Methicillin Resistant Staph Aureus (CA-MRSA).

Almost daily, I am treating patients, young and old alike, with this often-recurrent ailment. Patients typically present with "a spider bite," only soon to find out -- much to their dismay -- that they are the victims of this emerging community health threat. And the cause of this outbreak? Look no further than the physician's prescription pad.

In the war between bugs versus drugs, the germs are winning. The inappropriate prescription of broad-spectrum antibiotics for viral infections is doing nothing for the runny noses and hacking coughs these drugs supposedly cure. But, on the other hand, these antibiotics are doing everything to foster the mutation and proliferation of these (and other) super bugs. Case in point, the ubiquitous, highly demanded Z-pak is often powerless against CA-MRSA.

Fortunately, for now, this staph bug is usually treatable with simple lancing and a low cost, generic antibiotic; but what the future holds is uncertain. As the community at large continues to be bathed in excessive antibiotic prescriptions, the arsenal to fight CA-MRSA will likely continue to shrink. When all the drugs fail, what then?

RUSSELL J. BIRD, M.D.
Baptist Urgent Care Louisville 40243