The looming threat of antibiotic resistant infections
Originally published on Baxter Bulletin
In a recent commentary published in the Journal of the American Medical Association Dr. James. M. Hughes, a world authority on Infectious diseases at Emory University, sounded an ominous warning about the ever-increasing danger of infections that are resistant to most, if not all, available antibiotics.
Each year, these infections account for over $20 billion in health care costs and amazingly over 8 million additional and avoidable days stayed in the hospital. Not only is this an economic crisis, but also a national security threat as it is possible to engineer bacteria that are highly infective, leading to wide-spread national epidemics of infections for which no adequate therapy is available.
The treatment and cure of many serious diseases such as cancer and any illness in which susceptibility to infections is increased, is seriously compromised if an overwhelming infection resistant to all antibiotics is acquired. Just recently, a new strain of bacteria resistant to every known antibiotic is causing infections world wide that is becoming a global public health threat.
This problem is becoming ever more serious as the pipeline of development of new and more powerful antibiotics is now reduced to a trickle and is even drying up. Dr. Hughes points out that between 1983 and 1987, 16 new antibiotics were approved by the FDA compared to only two since 2008.
The dearth of drug development is made worse by the withdrawal of most pharmaceutical companies from antibiotic research. These drugs work too quickly and the profit margin is not as great as medications used to treat chronic diseases. And because the drugs are used inappropriately, resistance to them develops rather quickly.
There is such a crisis on the horizon that the major societies in infectious disease have issued a 10 by 20 initiative that commits key leaders to identify 10 new, safe and highly effective antibiotics by the year 2020.
To do this will require increased funding from congress here and by nations world wide as well as strong leadership from the FDA to assist in appropriate testing and approval within a reasonable time frame.
Sadly, this crisis has been brought on by both by the health care community who are too willing to prescribe antibiotics and to choose the newest and most heavily marketed over the tried-and-true older drugs and by the general public who have an insatiable demand for antibiotics for the treatment of virtually every malady.
The evidence is compelling that over 50 percent of prescriptions for antibiotics are unnecessary, of no value or even if needed, the choice is inappropriate.
All of us harbor bacteria on our skin, nose, sinuses and gastrointestinal tract that are harmless, provide invaluable nutrients and prevent the overgrowth of harmful bacteria that can cause serious disease. Prescribe a powerful antibiotic for a minor infection (that is often viral) and all the normal bacteria are killed off.
A void is created that is replaced by other bacteria that can lead to severe generalized infections, diarrhea and recurrent infections for which treatment becomes more and more difficult. And the older the patient the greater the possibility of a significant problem.
Dr. Hughes points out the value of educating the health care community to become less willing to prescribe unneeded antibiotics for conditions for which they are not indicated and to be judicious in the use of powerful antibiotics that should not be the first line approach to treating common infections. The evidence is compelling that bacterial resistance to antibiotics can be reduced by better use of antibiotics combined with controlling the spread of infections from patient to patient in hospitals and other health care facilities.
And you, the readers of this article, must develop understanding that antibiotics do not miraculously cure all symptoms. Chronic coughs, colds, sore throats, diarrhea, vomiting are usually caused by viruses. Sometimes coughs can reflect allergies and even if viral can last quite a long time. Listen to the doctor who wishes to temporize before prescribing an antibiotic and if given too quickly always ask of the drug is needed.
This is a serious problem that is reaching frightening proportions. And as we grow older and risks of serious diseases increases the threat of antibiotic resistance becomes ever more real.