Thursday, August 06, 2009
By Dr. Anthony Policastro

Patients must be evaluated before antibiotics are given The last time I was on call for a weekend, I received three calls asking me to prescribe an antibiotic without seeing the patient. The parents all felt that they knew what was wrong with the child. They did not want the child to be seen and just wanted to go pick up a prescription. I offered one of them an appointment to meet me at the hospital. I went to the hospital to meet them but they did not show up. Writing prescriptions for antibiotics without evaluating the patient has many associated problems. The first is that the patient's diagnosis may be wrong. The best example of this is ear pain. Ear pain can be due to an ear infection which means oral antibiotics. It can also be due to swimmer's ear which means ear drops. It can be due to TM joint pain which means pain relievers or it can be due to dental pain which means a visit to the dentist. Giving antibiotics only causes the patient to suffer longer if they do not have an ear infection. I have treated many children with meningitis. Quite a few of them had been given an antibiotic by their parent because an old prescription was still sitting around the house. The problem then becomes trying to figure out what is actually causing the meningitis. The antibiotic will mess up the culture but not cure the problem. The result was a longer course of IV antibiotics in the hospital. A second problem that can occur is allergic reactions to the antibiotics. Many people have allergic reactions to antibiotics. You are not born with an allergy to something; you develop the reaction after exposure. Thus the more times you take an antibiotic, the more likely you are to have an allergic reaction to it. A third problem is related to side effects from the antibiotic. Side effects are different than allergies. They are problems that someone develops to taking a certain drug. For example, some antibiotics cause abdominal pain while others cause diarrhea. Some even cause a form of colitis that needs to be treated with a different antibiotic. If it is not treated, the colitis can be fatal. A third problem is related to resistant bacteria. The more we use antibiotics, the more bacteria become resistant to them. Most people have viral illnesses. Antibiotics will not kill the virus. What they will do is kill all the bacteria in someone's body that are sensitive to that antibiotic. What is then left are resistant bacteria. If that patient is going to go on to get an infection, it will be with something that is harder to treat. The classic example of this is the burn patient. We know that burned skin is more likely to get infected than normal skin. For that reason, we used to give antibiotics to prevent those infections. However, we learned that patients still got infections anyway. They just got them with resistant bacteria which made them harder to treat. There are many reasons to be cautious about antibiotic use. Because of that, I like to evaluate patients to make sure we are doing things correctly. Some patients prefer the short cut which can be more dangerous. As we look at controlling the costs of medical care in this country, one of the things we need to do is only prescribe medications when the evidence suggests that we do. Using antibiotics for viral illnesses is not supported by evidence based medicine.

GET FIT AT DELAWARE TECH Get in shape this fall with programs offered at Delaware Technical & Community College, Owens Campus. Release tension and stress through a series of meditation, breathing, and stretching exercises in yoga on Monday evenings beginning Sept. 21 or Wednesday evenings beginning Sept. 23. Want to exercise at your own pace? Become a member of the Delaware Tech Fitness Center by signing up for the monthly or 16-week program. Training sessions with Jim Edgerton, certified personal trainer, are also available for individual help reaching fitness goals. The state-of-the-art gymnasium complex is open five nights per week until 7 p.m. and includes a basketball court, fitness center complete with a cardio/weight training room, exercise room, and locker rooms for men and women. Special discounts are available for seniors. For more information or to sign up for a program, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

DUPONT HOSPITAL HOLDS RAFFLE Nemours/Alfred I. duPont Hospital for Children is holding a raffle for a Harley-Davidson motorcycle. The motorcycle, a Soft-Tail Fat Boy in Black Denim that includes a riding gear safety package, was donated by Concordville Nissan-Subaru. Tickets are $25 each or five for $100 and proceeds benefit the hospital. The drawing will take place in the hospital lobby on Sept. 11 at 2 p.m. For ticket information, contact Kate Handling at 302-651-4383 or

NEMOURS RECEIVES AWARD At its inaugural "Weight of the Nation" Conference, July 27-29, in Washington, D.C., the Centers for Disease Control and Prevention (CDC) honored Nemours Health & Prevention Services of Newark, as one of eight national organizations at the forefront of advancing policies and environmental strategies to prevent and control obesity. Nemours earned the Pioneering Innovation award on the basis of its work to improve the health and well-being of children through an integrated system that includes community-based prevention and medical care. Through statewide work in schools, child care, primary care, youth-serving organizations and the built environment, Nemours has reached more than 100,000 Delaware children with its healthy behavior change initiatives.

HEALTH CARE INFO SESSIONS Looking for opportunities with a great starting salary in the expanding health care field? Attend a free information session on Monday, Aug. 17 from 6 to 8 p.m. at Delaware Technical & Community College, Owens Campus. Discuss new and existing health career certificate programs at Delaware Tech including certified nursing assistant, polysomnography technician, medical coding and billing, medical transcriptionist, health information coding specialist, and health information clerk. For more information or to sign up for this info session, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

OCCUPATIONAL HEALTH IS MOVING On Monday, Aug. 17, Nanticoke Memorial Hospital's Occupational Health Services will be moving to a new location at 543 N. Shipley St., Suite F in Seaford. The new location is dedicated to only Occupational Health clients. From treatment for work-related injuries and illnesses, DOT screenings, post incident testing, pre-employment physical examinations, to drug testing, Nanticoke's Occupational Health Services has been operating for over 20 years. For more information, contact Occupational Health Services at 302-629-6875.

STROKE SUPPORT GROUP TO MEET Nanticoke Memorial Hospital's next Stroke Support Group meeting is Thursday, Aug. 20 at 1:30 p.m. at Nanticoke Memorial's 2nd Floor Cancer Care Center Conference Room. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 302-629-6611, ext. 8626.

DR. WINGATE JOINS NMH Nanticoke Memorial Hospital welcomes Michael Wingate, MD, FACS to its active medical staff. Dr. Wingate, specializing in general surgery, is accepting new patients at his practice located at 701 Middleford Road, Suite 201, Seaford. Dr. Wingate is Board Certified by the American Board of Surgery and graduated from the State University of New York at Stony Brook. He completed his residency at West Virginia University, Ruby Memorial Hospital in Morgantown. His professional memberships include Fellow of the American College of Surgeons, The American Society of Breast Surgeons and the Surgical Infection Society. To reach Dr. Wingate's office, call 302-628-3294.

DR. OLOWO JOINS NMH Nanticoke Memorial Hospital welcomes Abimbola O. Olowo, MD to its active medical staff as a hospitalist. A hospitalist is a physician who specializes in the care of patients while they are in the hospital. Hospitalists work with specialists, nurses, or others involved with the patient's care, are available to the patient and their family for questions, and communicate with the patient's primary care physician. Dr. Olowo is board certified in internal medicine and completed his residency at Christiana Care Health System in Newark. He earned his medical degree at Northeastern Ohio Universities College of Medicine in Rootstown, Ohio.

VASCULAR CENTER OPENS AT NMH Nanticoke Memorial Hospital (NMH) announces the opening of The Vascular Center at Nanticoke Memorial Hospital. Nanticoke has assembled a team of physicians, nurses and technologists to provide the best care possible at The Vascular Center for conditions such as peripheral artery disease, deep vein thrombosis, abdominal aortic aneurysms, coronary artery disease, and carotid artery stenosis. Nanticoke Memorial Hospital also offers the latest technology for the diagnosis and treatment of vascular conditions, including an advanced 64-slice CT scanner, ultrasound imaging devices and angioplasty equipment. The practice of Vascular Surgeon, Nyen Chong, MD, (currently accepting new patients) vascular testing (previously performed at the Mears Campus and Radiology), and vascular screenings have all relocated to the new Vascular Center suite located on the grounds of Nanticoke Memorial Hospital next to the Wound Care & Hyperbaric Center. For more information, contact The Vascular Center at 302-629-0452.

CERTIFICATE PROGRAMS OFFERED Enroll in one of the new health career certificate programs offered by Delaware Technical & Community College, Owens Campus. New certificate programs include medical coding and billing, health information clerk, health information coding specialist and medical transcriptionist. "Medical terminology" is a prerequisite course for all of the health career certificate programs. Students will learn basic terminology in this 16-hour online course; the first session is Monday, Aug. 24 from 6 to 8 p.m. at the Owens Campus. In "Medical Coding and Billing" students will utilize basic medical terminology to understand the medical insurance claims process and reimbursement procedures; learn to identify and use special terms, marks, abbreviations and symbols used in the ICD-9 coding system. The course begins Tuesday, Sept. 22 at 6 p.m. "Health Information Clerk" prepares students for technical positions in health information management departments, physician's offices, long-term, home health and other health care settings. The course begins Monday, Nov. 2 at 6 p.m. In "Health Information Coding Specialist" students are trained to analyze patient health records in order to abstract information necessary to assign accurate ICD-9 and CPT codes. Course prerequisites are medical terminology and medical coding and billing; the health information coding specialist portion of the course begins Monday, Nov. 2 at 6 p.m. Prepare to be a medical transcriptionist by obtaining basic knowledge, understanding and skills required to transcribe medical dictation with accuracy, clarity and timeliness including medical terminology, human anatomy and physiology. The course begins Monday, Nov. 2 at 6 p.m. For more information or to sign up for courses, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.