Fighting Antibiotic Resistance

So often when a person is sick and goes to their doctor, they’re prescribed some antibiotics. Antibiotics are an amazing invention that has greatly improved our quality of life, and life expectancy, by helping us battle bacterial infections. But due to overuse, antibiotics have also created some extremely dangerous pathogens – antibiotic-resistant bacteria. On September 16, 2013, the Centers for Disease Control and Prevention (CDC) released a 114 page long report on just how widespread the problem of antibiotic-resistant bacteria is. They found that, each year in the United States, over 2 million people get infected with antibiotic-resistant bacteria. At least 23,000 people die directly from the infection, and more die from complications due to it.

The most damaging types of antibiotic-resistant bacteria that CDC identified are Clostridium difficile, carbapenem-resistant strains of Enterobacteriaceae (CRE), and drug-resistant Neisseria gonorrhoeae, all of which received an “urgent” threat level by the CDC. They estimate that each year almost 250,000 people are hospitalized, and at least 14,000 die, because of C. difficile infections alone, with antibiotic use actually being a primary factor leading to the infection. CRE is thought to cause 9,300 healthcare-associated infections, and 610 deaths, annually. (Carbapenem is considered a “last resort” antibiotic for treating certain infections.) And drug-resistant strains of N. gonorrhoeae cause about 246,000 infections annually, although they lead to fewer than 5 deaths. In addition, the CDC identified 12 microorganisms as having a “serious” threat level (including Methicillin-resistant Staphylococcus aureus, or MRSA, and other microorganisms that cause a greater number of annual deaths than the “urgent” threats), and three microorganisms with a “concerning” threat level. Clearly antibiotic-resistant microbes are a serious problem that needs to be addressed.

Overall, in their new report the CDC stressed the importance of reducing our use of antibiotics, for humans as well as other animals. They found that up to half of all antibiotic prescriptions are probably not needed, or they are not an optimal treatment strategy for the illness. (And, when a person takes antibiotics, they indiscriminately kill their “good” bacteria as well, which also reduces competition for antibiotic-resistant bacteria.) The CDC additionally reported that antibiotics should not be used in farm animals – such use is “unnecessary and inappropriate,” and likely contributes to the occurrence of antibiotic resistant strains. (If animals consume antibiotic-laded feed, they may have antibiotic microorganisms in their feces, which, if used in fertilizer for crops, may be transferred to food people consume.) Antibiotic use in animals should be completely eliminated. Overall, to decrease the presence of antibiotic resistant microbes, not only should we be using antibiotics a lot less – they should only be used when needed, and certainly not as an initial treatment strategy without considering alternatives – but we need to be more heavily pursing the development of new antibiotics as well.

So next time your doctor recommends a series of antibiotics to take care of a little cold, you may want to ask them about other options.

For further reading:

• The Centers for Disease Control and Prevention’s “Threat Report 2013”
• Tracy Vence’s article “CDC Charts Antibiotic Resistance Threat” at The Scientist
• Maryn McKenna’s article “CDC Threat Report: Yes, Agricultural Antibiotics Play a Role in Drug Resistance” at Wired