In the old days, if you got a cut or a wound and it became infected with bacteria, you had to cut it out. If you got a bloodstream infection, you died.
Then came along the era of antibiotics, beginning with penicillin.
But now we have a major problem: Antibiotic-resistant bacteria. Superbugs.
Doctors and scientists have known about the problem for some time.
For example, in a 2009 article for the New England Journal of Medicine, two doctors at the University of Texas Medical School in Houston described two scary examples with very different outcomes.
In March 1942, they wrote, a 33-year-old woman lay dying in a Connecticut hospital as her doctors could not eradicate her bloodstream infection. Then they administered repeated doses of penicillin and her bloodstream was cleared. She made a full recovery and lived to age 90.
Fast-forward to the present. A 70-year-old man in San Francisco in 2008 also had a bloodstream infection. The doctors wrote: “Despite the administration, for many days, of the best antibiotics available,” physicians “were unable to sterilize the patient’s blood, and he died still bacteremic.”
Their conclusion: We have “arrived at a point as frightening as the pre-antibiotic era.”
However, it was the Sept. 16 release of a report by the U.S. Centers for Disease Control and Prevention and the flurry of news stories since then – including a PBS Frontline program that aired last week – that finally brought the issue to the general public. Antibiotic resistance is urgent, requiring a public response.
The CDC statistics are alarming: “Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.”
Why is this happening? We have four major problems:
• Antibiotic overuse: The CDC calls this “the single most important factor leading to antibiotic resistance.” Half of the prescriptions for antibiotics are “not needed or are not optimally effective as prescribed.” We need a major antibiotic reduction campaign to educate doctors and the public that “antibiotics are not the solution for every illness.”
• Farm animals: The CDC said, “The use of antibiotics for promoting growth is not necessary, and the practice should be phased out.” Antibiotics routinely are added to water or animal feed. U.S. Sen. Dianne Feinstein of California has introduced a bill, the Preventing Antibiotic Resistance Act of 2013 (S 1256) that would require drug companies and producers to demonstrate they are using antibiotics to treat clinically diagnosable diseases, not to fatten livestock. Unfortunately, this bill has run into a buzz saw of opposition from beef and pork producers, as well as pharmaceutical companies.
• Declining research: The number of new antibiotics continues to decline. Drug companies make money from blockbuster drugs for chronic diseases; shorter-course drugs, such as antibiotics, are less profitable. This is where government-supported research needs to step in. Unfortunately, where President Barack Obama has proposed major increases in science research funding, House Republicans have proposed deep cuts. This is very shortsighted.
Passage of the Strategies to Address Antimicrobial Resistance Act (HR 2285) would help.
• Tracking: A network of 10 states, including California, reports on “emerging infections,” but we need nationwide tracking of antibiotic-resistant infections and antibiotic use. HR 2285 would direct the CDC to report every two years on resistance trends, threats and antibiotic use.
If we do not want a return to the days when people routinely died or lost limbs to bacterial infection, we have to make antibiotic resistance a public priority.