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What You Should Know About Antibiotic Safety

This is Antibiotic Awareness Week. While antibiotics save countless lives every year, using them improperly can have serious consequences. Dr. Raghavendra Tirupathi, Medical Director of Keystone Infectious Diseases, shares some important information everyone should know about antibiotic safety.

What is an antibiotic?

Antibiotics are medicines that help to stop infections caused by bacteria. They do this by killing the bacteria, or by keeping them from reproducing. Penicillin, one of the most widely-used antibiotics, was discovered by Alexander Fleming in 1928. This event revolutionized the treatment of many life-threatening infections. Subsequent discoveries of antibiotics have made organ transplants and cancer treatment possible and have made surgeries less risky. However, antibiotics only treat bacterial infections – they cannot treat infections caused by viruses.

What is antibiotic resistance?

Antibiotic resistance is usually due to excessive use of antibiotics. When antibiotics are used incorrectly, bacteria can change or adapt in a way that makes the antibiotics ineffective.

Why should I care about antibiotic resistance?

The ever-growing problem of antibiotic resistance leaves us with fewer effective antibiotics to treat deadly infections. Many of the modern medicines we use today may eventually become obsolete. This has the potential to turn even minor infections deadly. In the United States, antibiotic resistant bacterial infections lead to 23,000 deaths and more than 2 million illnesses annually.

What are the causes of antibiotic resistance?

Some of the main causes of antibiotic resistance are: the overprescribing of antibiotics, patients not taking antibiotics as prescribed, patients not completing their antibiotic course, poor infection control in hospitals and clinics, unnecessary antibiotic use in agriculture and poor hygiene and sanitation practices.

How do I know if I need an antibiotic?

Your doctor will be able to decide whether an antibiotic is necessary to treat your condition. Some common illnesses are caused by viruses, and antibiotics will not be helpful.

Some common conditions that are caused by bacteria and do require antibiotics are: strep throat, urinary tract infections and whooping cough.

Some common conditions that may require antibiotics are: sinus infections and middle ear infections.

Some common conditions that are caused by viruses and do not require antibiotics are: common colds, runny noses, bronchitis or chest colds in otherwise healthy children or adults, the flu and sore throats (that are not strep).

In the next article, I will discuss steps you can take to help prevent antibiotic resistance.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Give Thanks

This holiday season, we’re on a mission to say thank you to our employees for making a difference in people’s lives every day!

Maybe you have a story you could share with us: Has one of our doctors, nurses, or another staff member made a difference in your life? Do you want to say thank you to a receptionist who always has a great attitude? Has one of our employees gone above and beyond their job requirements to help you? Maybe an entire office always gives you a great experience.

We want to hear from you!

Please send your thank you story to, and we will pass it along.

If you prefer to mail a thank you note, you can send it to:

Keystone Executive Office
22 St. Paul Drive
Suite 200
Chambersburg, PA 17201

If we use your story in future advertising efforts, we will remove identifying information, such as your last name.

Thank you for your help!

Employee Spotlight — Erin Potteiger

The Keystone Health Employee Spotlight for November shines on Erin Potteiger, Certified Occupational Therapy Assistant at Keystone Pediatric Therapies!

Erin began working at Edlantis Achievement Center in October 2015. In April of 2016, when Keystone acquired Edlantis and renamed the office Keystone Pediatric Therapies, Erin became part of the Keystone family.

“There is such a friendly atmosphere working at Keystone, and everyone in the office is like family,” Erin said.

“I absolutely love working with kids and helping them work towards their goals for their daily, functional tasks through various games and activities. It’s so rewarding to see the kids accomplish and meet goals and is often amazing to see how far each of the kids has come. I’ve built a rapport and a bond with each of the kids that I treat and their families, and I always try my best to do everything I can to help them achieve their goals.”

Erin begins her workday at 8 a.m. and clocks out at 6:30 p.m. In the hours between, she provides treatment sessions for between seven and 11 patients.

“After each treatment session, I take time with the child’s parent to discuss how their child worked during the session as well as skills that were addressed,” she said. “Many of the skills that are addressed during treatment sessions include problem solving, following directions, self-regulation, planning and organization, as well as various motor skills such as fine, gross, visual motor and motor planning. Currently, I am supervising an Occupational Therapy Assistant student from Penn State Mont Alto and will be working with her until the beginning of December.”

When she’s not at work, Erin enjoys camping with her family at Raystown, backyard campfires, and traveling. Some places she has traveled to include Wyoming, Colorado, Montana, several Hawaiian islands, Niagara Falls, and Gatlinburg and Pigeon Forge in Tennessee.

“I really enjoy living in the Chambersburg/Franklin County area because I like how small each surrounding town is and I truly enjoy the country side,” she said. “I live in Shippensburg, PA with my husband, Brandon and our Yorkie Poo, Gracie. I have been married for two years and we are currently expecting our first baby, which we are very excited about!”

Thank you, Erin, for all that you do for Keystone and our patients!

What To Do When Your Child Has A Cold

As children return to school, an unwelcome guest visits many families – the common cold. Dr. Arnauld Oreste of Keystone Pediatrics Waynesboro shares what you need to know about helping your children treat and prevent the common cold.

What are the usual symptoms?

Sneezing, nasal congestion, a runny nose, sore throat, cough, low grade fever and headache often accompany a cold.

How can I help my child feel better while recovering from a cold?

Make sure they drink plenty of liquids as hydration helps fight off the cold. If your child is old enough to drink warm liquids such as tea and soup broth, these may soothe sore throats and help loosen nasal congestion. Using a humidifier may also help.

Topical saline may provide nasal relief. In infants, topical saline is applied with saline nose drops and a bulb syringe. In older children, a saline nasal spray or saline nasal irrigation (such as a squeeze bottle or neti pot) may be used. It’s important that saline irrigation be prepared from sterile or bottled water; it’s possible for serious infections to occur from using tap water.

If your child is twelve or older, over the counter decongestants may be helpful. These products should not be used on younger children, as their bodies may not be able to properly process the medication.

Low-grade fevers may occur during the first few days of the illness. If the fever is causing your child discomfort, acetaminophen may be helpful for children older than three months, or ibuprofen for children older than six months.

How can I help them stop coughing?

While coughing can be irritating, it plays an important role of clearing secretions from the respiratory tract. I suggest coughs be relieved with hydration and warm fluids, honey (in children older than one year), or cough lozenges or hard candy in children whom are not at risk for choking on them.

How long does a cold last?

In infants and young children, symptoms are usually worse on the second or third day of illness, and then gradually improve over 10 to 14 days. The cough may linger, but should steadily resolve over three to four weeks. In older children and adolescents, symptoms usually clear in five to seven days, though it may take longer in those with lung disease or who smoke cigarettes.

When should my child see a doctor?

If symptoms worsen or last longer than noted above, your child has difficulty breathing or swallowing, and/or has a high fever or a cough that doesn’t go away, you should seek medical attention. These could be signs that the cold has developed into something more serious, such as pneumonia or pertussis.

How can colds be prevented?

The best ways to prevent spreading or catching a cold are frequent handwashing and avoiding touching one’s mouth, nose and eyes. Disinfecting surfaces with products such as Lysol may help decrease the transmission of viruses.

There is not an immunization to prevent the common cold, but there are immunizations to prevent some of the viruses that can cause similar effects. Yearly flu vaccines are recommended for all people older than six months.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Keystone Pediatrics Waynesboro Trick or Treat Event

Join us on Saturday, October 28 for this free event! For more information, call (717) 387-8060.

What Parents Can Do About Bullying

With the start of a school year, kids and teens often face new and stressful situations. Unfortunately, one of the main sources of stress can come from their classmates – bullying. Trond Harman, Licensed Clinical Social Worker at Keystone Pediatrics Chambersburg, shares some important information all parents should know about the subject of bullying.

What are some clues that your child may be bullying others?

The main thing that you want to check on is your child’s social media accounts. This is the best way to tell because many kids will use this to bully other children. Some kids may not even realize that things they are putting on their social media accounts are considered bullying until their parents let them know. You may see other changes in your child’s behaviors, such as acting more intimidating, changes in language, increased back-talking, etc.

What steps should be taken if you feel your child is bullying others?

The first step is discussing with the child what behaviors they are showing that are considered bullying. Then ask them if they are being bullied themselves. Kids who are bullied will sometimes become bullies themselves as a way to feel better emotionally. Another question to ask your child is whether someone is putting them up to bullying or if they are being pressured to bully others. There are many problems with gangs and other groups pressuring kids to engage in behaviors as a way of initiation. Ask yourself: Has your child been angrier recently or do you notice them engaging in behaviors that you would not approve of? Finally, you should be aware of what behaviors you might be displaying that could cause your child to think that bullying is okay. As a parent myself, I sometimes question if some of what I might say or do would give my children a signal that being mean to others is okay.

What are signs your child or teen may be suffering from bullying?

There can be numerous signs that your child is being bullied. The main one is school avoidance or social isolation. I hear many parents tell me that their child is reluctant to go to school and it is a fight to get them out the door. Many times, I will speak to the child and they will state that they are being bullied at school, but were too afraid to tell their parents because the bully will threaten them. The child may not like to engage in previously enjoyable activities. They may cry more easily or even attempt to take something to school to protect themselves. It is not uncommon for a child to attempt to carry a pocket knife to school.

What steps should you take if you do find your child is a victim of bullying?

You need to be supportive. The parent needs to reassure the child that everything will be ok. Things will get better and we will support you through this struggle. Parents should talk to the school and see how they can help with resolving the issue. If the situation is severe enough, it may have to go to the authorities, but that is normally something the school can decide. I would have your child speak to a school counselor as soon as possible to determine how much effect this situation has had on them based on how long they have been victimized. If the symptoms are serious enough, then you may want to seek professional help immediately.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Employee Spotlight – Christy Strong

The Employee Spotlight for October shines on Christy Strong, Licensed Practical Nurse at Keystone Women’s Care!

Christy’s journey at Keystone began not as an employee, but as a patient. “I was a patient of (Certified Nurse Midwife) Kim Amsley-Camp,” she said. “At the time, I was working at a nursing home in Gettysburg. While attending a prenatal appointment, one of the nurses told me that there was a full-time opening at the office. I immediately filled out an application and was hired at 24 weeks gestation!”

Nearly eight years later, Christy is glad she made the transition.

“My favorite parts of my job are the patients, my amazing work family, and the nursing supervisor here,” she said. “I’m also incredibly blessed to work with an amazing group of providers. The environment is very friendly and caring, and I enjoy learning and exploring new things in this office. I’m always trying to find a way to help and improve the quality of patient care, and I’ve had some wonderful patients that I have become friends with outside of work. Keystone is a fun place to work. I simply love my job.”

She’s also glad to work for a company that puts its patients first.

“Keystone Health truly complies with their mission statement,” Christy said. “Keystone makes several practices available to the community, including new and expanding facilities. They offer healthcare to the uninsured, and there are financial counselors and navigators who are available to set up payment arrangements for the patients. Joanne Cochran is a true advocate in supporting Federally Qualified Health Centers.”

Christy’s workday begins at 7 a.m. and doesn’t end until 5:30. As Certified Nurse Midwife Emily Hoger’s primary nurse, she tries to keep the day running as smoothly as possible. After opening her rooms and making sure she has all the needed supplies, Christy looks at her schedule and tries to map out the day – though that can easily change. She keeps busy by rooming patients, documenting and updating their charts, giving injections and immunizations, and more. When Emily is out of the office, Christy assists with whatever is needed, including helping the triage and prenatal nurses.
“Knowing that I can make the slightest difference in a patient’s day makes me feel proud about the work I do. Whether it’s scheduling an appointment, making a phone call, explaining a procedure, talking to a patient about their day, holding a patient’s hand, or listening to their concerns – it makes me feel confident in my work as a nurse. My day is hectic and busy, but it goes by extremely fast.”

While Christy grew up in West Mifflin, Pennsylvania, just outside of Pittsburgh, she now calls Chambersburg home. She lives here with her husband Ken, and their two sons: Jake who is 7, and Ben who is 6.

“Outside of work, I’m a full-time mom,” she said. “I like to volunteer at Hamilton Heights Elementary School on my day off. I love being active with my boys and spending time with family. I enjoy the little and simple things in life like being outside, hiking, and walking, I enjoy making crafts, decorating, shopping, and cooking. I also enjoy road trips back to Pittsburgh! Chambersburg is a very warm and friendly community. I’m also happy that the area is growing and we are bringing more business and development to the area. I appreciate the pretty views of the mountains and love the State and local parks that surround Franklin County.”

Thank you, Christy, for all that you do for Keystone and our patients!

Diabetes Health Fair

Join us on November 4th for our 2017 Diabetes Health Fair!

What Parents Need To Know About Bullying

With the start of a school year, kids and teens often face new and stressful situations. Unfortunately, one of the main sources of stress can come from their classmates – bullying. Trond Harman, Licensed Clinical Social Worker at Keystone Pediatrics Chambersburg, shares some important information all parents should know about the subject of bullying.

Why is bullying such an important issue?

Bullying is an important issue for us to address as a society due to the prevalence of it and the effects that it has on children. Bullying seems to have gotten worse in recent years and especially within the past year. Bullying has gone from teasing and picking on someone to making threats on their life. Our society has witnessed a recent problem with racism that seems to be carrying itself into our schools. Bullying has also gotten a new platform as many kids now engage in cyber bullying, which is something that was not seen in the past. This is more severe as it subjects the target to potentially have hundreds of others engage in bullying behaviors.

Bullying is something that is not always thought of as having a lasting impact on the lives of children, but this is not the case. There are many instances when bullying has led children to take severe measures to get out of the situation. It is important as a parent, and that we as a society, never take bullying too lightly or sweep it under the carpet.

What are the immediate effects of a teen or child being bullied?

Some of the immediate effects of bullying on kids are social withdrawal or isolation from others. Kids will begin to have an increase in their anxiety level and show more symptoms of depression. The increase in anxiety symptoms is especially true when in a social situation or doing things that they previously enjoyed.

Can there be long-term effects?

The long-term effects of bullying can be severe. I have had numerous clients that are victims of bullying and show many signs of trauma. The symptoms of trauma do not go away easily and can take years to overcome. Due to the increase in anxiety level and the traumatic effects of bullying, there are kids that will turn to self-mutilating behaviors – the most prevalent of these is cutting.

How can parents talk to their kids about bullying?

Parents need to have open and honest communication with their children. They should never close the door to communication with their child whether the behaviors are positive or negative. If you believe that your child is the victim of bullying, it is again important to keep an open and honest communication line with them. Ask questions about behaviors that you are observing with them that are not normal. Why do you not want to go to (name of their activity)? You seem to be crying a lot recently, is everything ok? Or you seem to be more on edge, is something bothering you? These are the types of questions that can open up that line of communication. It is amazing to me, but kids will not tell their parents how they are feeling, unless they are asked. Many kids tend to keep their feelings bottled up inside of them, which causes many other problems.

In the next article, I will discuss specific steps that parents can take if they find their child is being bullied, or if they discover their child is bullying others.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

How To Protect Yourself From Lyme Disease

With the fall season nearly upon us, the crisp, cooler weather provides a great time to enjoy outdoor activities such as hiking and camping. However, wooded areas are prime spots for ticks to thrive. Dr. Raghavendra Tirupathi Govindaraju, Medical Director of Keystone Infectious Diseases, shares some important information about Lyme disease and how you can help to keep you and your family safe.

What is Lyme disease?

Lyme disease is an infection most commonly caused by a bacterium called Borrelia burgdorferi. In the United States, people are more likely to be infected during the summer and fall months. Pennsylvania is one of the states where the disease is most prevalent.

How does someone get Lyme disease?

Lyme disease is spread to humans through the bite of infected blacklegged ticks (also known as deer ticks). In order for a tick to transmit the infection to humans, it needs to be attached to a person’s body for at least 24 hours. Ticks attach to a person or animal by crawling; they cannot fly or jump. They can attach to any body part, but are more commonly found in areas such as the scalp, groin, and armpits.

What are the initial symptoms?

Typical early symptoms include fever, headache, fatigue, muscle and joint aches, swollen lymph nodes, and a bullseye-like skin rash called erythema migrans. This rash can appear 7 to 30 days after the tick bite and can reach a size of up to 12 inches or larger. The rash is rarely itchy or painful.

What are the long-term effects?

If left untreated, the infection can spread to joints, the heart, and the nervous system. It can cause additional rashes on other areas of the body, inflammation of the brain and spinal cord, facial paralysis, nerve pain, joint pain, heart palpitations or an irregular heartbeat, and swelling — particularly in the knees and other large joints.

How is Lyme disease diagnosed?

Lyme disease is diagnosed by a physician based on a person’s signs and symptoms, and history of possible or known exposure to infected blacklegged ticks. Laboratory blood tests can also be helpful in some cases.

How is it treated?

Lyme disease is treated with antibiotics. Patients with certain neurological or cardiac illnesses may require intravenous treatment with drugs such as ceftriaxone or penicillin.

How can people protect themselves against Lyme disease?

The best way to prevent Lyme disease is by preventing tick bites. Avoid wooded and brushy areas as much as possible. If you are planning to spend time outdoors, use a tick repellent that contains 20% or more DEET, picaridin, or IR3535 on exposed skin. This protection lasts several hours. When hiking, stay in the middle of trails and try to keep away from leaf piles, tall grass and brush. Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off any ticks that could be crawling on you.

Check your entire body for ticks after being in areas where they are common. While ticks are most often found in wooded, grassy or brushy places, they may also be present in gardens or lawns. Keep in mind that ticks can also attach to animals and be brought into houses by pets. Tick control products may be helpful in reducing the chances of your pet carrying ticks. Taking proper precautions can greatly reduce a person’s chance of being infected with Lyme disease.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.