In the U.S. and abroad, humans are at risk of increasingly weak antibiotics and increasingly strong superbugs. Before the discovery of penicillin in the early 20th century, a significant portion of people unlucky enough to contract a bacterial infection died. With increasing antibiotic resistance, we risk a post-antibiotic era every bit as frightening.
A report out this month from the Centers for Disease Control and Prevention highlights multidrug-resistant bacteria as one of the world’s most serious and pressing health threats. “Antibiotic Resistance Threats in the United States, 2013” notes that drug resistance is often the result of poor stewardship, defined as the lack of careful use of antibiotics in humans and animals.
When antibiotics are used unnecessarily or inappropriately, we kill the most susceptible organisms and, in their void, create a more favorable environment for the selection of more-resistant bacteria. This has resulted in a scary alphabet soup of superbugs, including C. diff, CRE, MRSA, multidrug-resistant TB, and VRE, that can be deadly to those with suppressed immune systems and are threatening even the healthiest patients.
The CDC’s strategies to address resistance include tracking resistant bacteria, improving uses of antibiotics, and developing new antibiotics and diagnostic tests for resistant bacteria. But success also means reducing the overuse of antibiotics and requires a commitment from more than health professionals. Patients need to change their expectations for receiving an antibiotic when an illness is likely viral—in which case it will never respond to an antibiotic—or self-limited, like a cold that will go away on its own. Doctors need to feel supported by patients, not pressured, when they exhibit prudent stewardship in prescribing only those medicines that will be effective.
Preventing infection is another critical piece of the CDC’s national strategy, and we still have a lot to learn on that front. That is why Hospital Corporation of America, in partnership with researchers from the CDC, Harvard Pilgrim Health Care Institute and Harvard Medical School, University of California Irvine School of Medicine, Rush Medical College and Washington University, recently conducted a study known as Reduce MRSA (short for the Randomized Evaluation of Decolonization Versus Universal Clearance to Eliminate MRSA).