Since the discovery of penicillin in 1929, antibiotics have changed the landscape of medicine and disease. In most ways, that change has been good – thanks to antibiotics, the threats of pneumonia, tuberculosis, meningitis and many, many other bacterial diseases has been greatly lessened. However, increased use of antibiotics around the world has also lead to new health care concerns; chiefly, the growing problem of drug-resistant bacteria.
For years, doctors have warned about the dangers of incorrect antibiotic use; taking antibiotics when ill with a virus, for example, or not finishing an entire course of a prescribed antibiotic. In both of these situations, the patient risks creating antibiotic-resistant bacteria within their own body, and then passing that bacteria on to other people as well. Drug-resistant bacteria can be created in other ways as well. Counterfeit antibiotics, which are especially prevalent in Africa and Southeast Asia, have received quite a bit of media attention earlier this year for having led to drug-resistant, difficult-to-treat strains of tuberculosis.
But even though health care professionals have known for years that antibiotic-resistant bacteria poses a threat, a report released this week estimating that 23,000 people in the United States die every year as a result of drug-resistant infections still came as a shock. The report was conducted by researchers from the U.S. Centers of Disease Control and Prevention (CDC), and by most accounts seems to have underestimated the death toll due to antibiotic resistance. Director of the office of microbial resistance with the CDC, Dr. Steven L. Solomon has said that report authors underestimated the threat of antibiotic-resistance in order to come up with a conservative estimate of the threat of infections that won’t respond to antibiotic treatment.
Of course, 23,000 deaths every year hardly looks like a conservative figure. Many people have been shocked by the CDC’s report, and surprised to learn that drug-resistance is such a significant problem in the United States. In addition to the fatalities recorded, researchers also found that around two million Americans become ill every year as a result of drug-resistant bacteria, which may lead to deaths that, while not directly caused by the antibiotic-resistant infection, are still linked to its presence.
Some health professionals fear that antibiotic resistance may mean the increase of infectious diseases that have for a very long time not been of huge concern to the public. Staph infections, for example, can normally be treated very easily with a course of antibiotics, however in the past few years, the United States has seen an increase in staph-causing bacteria that’s resistant to most antibiotic drugs currently on the market. Known as methicillin-resistant Staphylococcus aureus, or MRSA, this bacteria can cause skin infections and lead to life-threatening cases of pneumonia. MRSA can also be responsible for infections in patients who have recently undergone surgery, which is one reason that hospitals have strongly focused on keeping this superbug out of hospitals.
Because MRSA bacteria can live in a person who doesn’t show any outward signs of infection, the disease can be unknowingly spread. This issue is especially prevalent in a hospital setting, when direct contact with an infected wound can lead to contamination and further infection. Then, because MRSA cannot be easily treated with antibiotics, a resulting infection in an already ill patient can lead to further immune system damage and health complications.
Besides the issue of drug-resistant disease within a health care setting, the recent report from the CDC also highlighted the issue of antibiotic use in animals, and how those farming practices might lead to resistance to antibiotics in humans. As with humans, livestock are often given antibiotics to prevent infection; especially when those animals are kept in close quarters with one another and therefore at more risk of spreading disease to one another. However, because around 70 percent of the antibiotics given to animals are also given to humans, antibiotic use on farms could be contributing to drug-resistant infections in people as well.
The problem of antibiotic-resistant infection in the United States mirrors issues occurring around the world. Drug-resistant tuberculosis is a huge issue for patients and health care workers, especially in India and other parts of Southeast Asia. Even more worrying is the prevalence of multidrug-resistant tuberculosis, a strain of the disease that doesn’t respond to any of the most commonly prescribed antibiotics. This type of drug resistance has primarily resulted from misuse of antibiotics; patients will fail to finish a course of the antibiotics, or take less than the recommended daily dosage in order to share the medicine with other family members. Health workers are hoping that through the myriad education and action plans going on right now, antibiotic-resistant tuberculosis can be stopped.
Indeed, education is perhaps the best way to prevent the development of drug-resistant infections. When patients are aware that antibiotics cannot cure the common cold, they are less likely to take the unnecessary medication and unwittingly create a new generation of bacteria resistant to that antibiotic. Similarly, patients must be educated on the importance of finishing their full course of antibiotics, even if no signs of illness remain. In developing countries, instructive campaigns can also explain the dangers of using a counterfeit drug, which may contain only trace amounts of the antibiotic and therefore fail to kill all bacteria; of course, that remaining bacteria will grow, and potentially lead to a drug-resistant strain of the original infection. Education is a powerful tool, and in the United States and around the world, information can have a huge impact on preventing disease that won’t respond to antibiotics.