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The misuse of antibiotics is causing healthcare professionals and the public to reconsider their use in future treatment, according to the U.S. Centers for Disease Control and Prevention (CDC). A CDC publication, “Threat Report 2013" (1), states that every year nearly 2 million U.S. citizens acquire an infection that is antibiotic resistant. Of these, almost 23,000 people die from these infections. We may already be in a post-antibiotic phase where new treatments will need to be developed.
The Antibiotic Heyday May Be Over
The heavy use of antibiotics can kill off microbes that respond to the drug, leaving those in the body that are resistant. This creates a fertile ground for those bacteria to multiply and even pass their drug-resistance on to other microbes. This can result in a new infection in a person with no available antibiotics to treat it. For children, the elderly and people with a compromised immune system, this secondary infection could be fatal.
There are few options in this post-antibiotic era other than reduce the evolution of drug-resistant microbes and develop new treatment methods. The CDC lists four actions to reduce the occurrence of drug-resistant microbes:
- Increase immunizations to prevent infections from starting
- Institute hand-washing and other techniques to reduce the spread of infections
- Track drug-resistant bacteria more carefully once identified
- Enforce the judicious use of antibiotics
They also urge the development of new drugs for the treatment of infections and test procedures to quickly diagnose infections.
The High Cost of Antibiotic Misuse
A study by Tufts University(2) estimates that drug-resistant infections cost as much as $20 billion each year. They estimate lost productivity to add another $35 billion. Patients with a drug-resistant infection can expect to see their medical costs increase from $18,000 to $30,000 per incident.
The Causes of Misuse
Unfortunately, patient demand is one reason for excessive antibiotic use. In an interview with Daniel Uslan M.D., director of the UCLA Antimicrobial Stewardship Program(3), he states that there was a high incidence of over-prescribing of antibiotics in outpatient settings. Patients asked for, and received, prescriptions for sore throats, ear infections and other medical conditions that were likely viral and not bacterial in nature.
The CDC says that physicians prescribed antibiotics 62 percent of the time for pediatric patients if the parents expected them, but only 7 percent if the parents did not(4). In adults, acute respiratory tract infections were treated 68 percent of the time with antibiotics when only 20 percent actually met the criteria for that type of treatment. It’s estimated that $1.1 billion is spent on unnecessary antibiotics ever year to treat adult respiratory illnesses.
The Way Out
The CDC is seeing a reduction of antibiotic prescriptions(4) due to education campaigns focused on healthcare providers. The “Threat Report 2013" (1) was written for the public as well as the medical community to give visibility to the problem. Continued education and awareness appear to be effective. The medical community is still waiting for alternatives to antibiotic treatment to be developed.
- (4) Centers for Disease Control and Prevention, “Get Smart: Know When Antibiotics Work”, http://www.cdc.gov/getsmart/antibiotic-use/fast-facts.html, 21 Jan. 2011
- (3) Eryn Brown. “Drug-resistant superbugs multiplying: CDC report IDs 'urgent threats’.” Los Angeles Times, http://www.latimes.com/science/sciencenow/la-sci-sn-cdc-antibiotic-resistance-20130916,0,2212114.story, 16 Sep. 2013
- (2) Tufts University, “The cost of antibiotic resistance to U.S. families and the health care system”, http://www.tufts.edu/med/apua/consumers/personal_home_5_1451036133.pdf, Sep. 2010
- (1) Centers for Disease Control and Prevention, “Threat Report 2013”, http://www.cdc.gov/drugresistance/threat-report-2013/, 16 Sep. 2013