We All Must Get Smarter About Antibiotics

December 5, 2016 by CDC's Safe Healthcare Blog

Christian John Lillis, Executive Director, Peggy Lillis Foundation

Guest Author: Christian John Lillis ,
Executive Director, Peggy Lillis Foundation

I had scarlet fever when I was six years old. The infection had me in the hospital for a week, while the doctors struggled to diagnose my illness and then managed my treatment with antibiotics. One of my earliest memories is being shaken awake at least twice a night by a large, looming nurse to take another oral dose of antibiotics.

From the mid-nineteenth century through the Second World War, scarlet fever was a significant cause of childhood death causing upwards of 60,000 deaths at the turn of the century. Though death rates were decreasing throughout the 20th century1, it was the discovery and use of antibiotics that made scarlet fever a manageable illness. Luckily for me, by the time I was diagnosed in 1979, the antibiotic penicillin was widely available. My mother took me home following my week-long stay in the hospital.

Though antibiotics likely saved my life, they were also presumed to be responsible for my adult teeth coming in discolored and with overly porous enamel. Every dentist I saw, including the one who eventually helped remove some of the discoloration, blamed the huge doses of antibiotics I was given as child. Despite having otherwise straight and nicely shaped teeth, the discoloration always bothered me.

The Story of Peggy Lillis The Other Side of Antibiotics

Unlike a lot of Americans, I’ve rarely used antibiotics throughout my life. While in high school and college, I tended to get strep throat at least once every winter. The doctor would always prescribe antibiotics and I would never take them. Instead, being a “young invulnerable,” I felt I could fight it off myself. I would gargle with warm salt water, drink tea, and live on cherry cough drops. I was never sick for more than 10 days and by the time I was 25, the bouts of strep stopped. Thankfully, I did not have any complications from strep throat and remained healthy in my 20s and 30s. But truthfully, I rarely thought about antibiotic use.

That changed with the death of my mother Peggy Lillis on April 21, 2010 from a Clostridium difficileinfection. Like so many other Americans, my mother’s deadly C. diff infection began with her being prescribed a prophylactic dose of an antibiotic, clindamycin, following a root canal. Within four days, she began to experience diarrhea. Ten days after beginning her course of antibiotics, she was dead. Prior to my mother’s death, I would never have imagined that an antibiotic could precipitate a deadly disease. Like many Americans we had never heard of Clostridium difficile. Nor did we realize the system-wide effects that many antibiotics have on the body.

I’ve wondered since Mom’s death if knowing how antibiotics had affected my teeth made me subconsciously reticent to take them.

In our mother’s memory, my brother Liam and I founded the Peggy Lillis Foundation (PLF) to raise C. diff awareness and advocate for policy changes to combat the disease. A key element of our work is educating the public about the judicious use of antibiotics. To that end, we team up with organizations like the Centers for Disease Control and Prevention (CDC) to share stories like our mother’s, provide the patient and caregiver perspective, and develop shared goals and strategies.

Throughout this year, we’ve been working with CDC and other organizations to raise awareness of the role of antibiotics in causing C. diff infections. Examples include:

PLF partnered with the Antibiotic Resistance Action Center, Milken Institute School of Public Health, Consumer Reports, Small-r Films, and Delmarva Foundation to co-host a Washington, DC screening of Resistance, a documentary about the history and future of antibiotic resistance.

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PLF represented C. diff patients at the June 2016 and September 2016 public meetings of the President’s Advisory Council on Combating Antibiotic Resistant Bacteria.

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PLF worked with the National Quality Forum’s (NQF) Antibiotic Stewardship Task Force charged with designing a Playbook to aid hospitals in implementing antibiotic stewardship programs. We played a prominent role in the development and launch of the Playbook, including ensuring it centers on patients and families, speaking on a panel at NQF’s annual conference, and launching a webinar in May.

For this year’s Get Smart About Antibiotics Week, we worked with CDC on a new video about our mother’s story. The video clearly demonstrates that antibiotic use can lead to real harm, even death.

I am living proof that antibiotics are incredibly important and vital drugs. At the same time, my mother would likely still be alive today if she’d never taken that course of clindamycin.

Antibiotics can save lives. But antibiotics can take lives too. The difference in our two outcomes demonstrates how desperately we need to be smarter about antibiotics.

1 Smallman-Raynor, Andrew Cliff, Peter Haggett, Matthew (2004). World Atlas of Epidemic Diseases. London: Hodder Education. p. 76. ISBN 9781444114195.

December 5, 2016 by CDC's Safe Healthcare Blog

Antibiotic Resistance and Antibiotic Use (Stewardship)