Antibiotic Resistance: Not a New Problem, but Quickly Getting Worse
by June Baldwin
The intriguing title of Dr. Tom Frieden's talk at the National Press Club on 22 July 2014 was "MERS, Public Enemy Number One?" He explained that the Middle East Respiratory Syndrome (MERS, a corona virus) is a serious concern because of its virulence, lack of a cure, lack of a vaccine, and unknown method of transmission, but it can successfully be contained by standard infection control practices. The next pandemic is not likely to be MERS unless the virus mutates such that its spread cannot be contained. The looming worldwide health threat is actually antibiotic-resistant bacteria. From the infectious disease perspective, human history can be divided into the pre-antibiotic era and the antibiotic era. Bacteria are changing quickly and we are in danger of ushering in a post-antibiotic era if current practices continue. A study done by the Centers for Disease Control and Prevention (CDC) showed that about one-third of the antibiotics prescribed in hospitals were unnecessary or inappropriate, and this contributes to the development of antibiotic resistance. In fact, the most resistant organisms that we are dealing with in the present time originated and are spread in hospitals. Drug-resistant infections result in 23,000 deaths in America each year. In a post-antibiotic era, the numbers of deaths due to infections would rise, the economy would be devastated, and the practice of medicine would be greatly hampered. Without effective antibiotics, imagine how difficult, if not impossible, infection control would be for doctors treating patients who are at increased risk of infection, such as those undergoing cancer chemotherapy, those on renal dialysis, or those receiving immunosuppressive treatments for autoimmune conditions such as arthritis. What is the solution? Through better detection (such as tracking of antibiotics dispensed and evaluating resistance patterns in hospitals), better control (stopping the spread), better prevention (improved prescribing practices), and innovation (development of new drugs), the tide of antibiotic resistance can be reversed.
The event was attended by many journalists, members of AMWA-MAC, and members of the general public. Interestingly, the preponderance of questions during the question & answer period at the end of Dr. Frieden's talk had to do with another issue entirely: the recently publicized safety lapses at CDC labs involving anthrax and bird flu pathogens, for which Dr. Frieden was called before Congress in mid-July to address. The full transcript from the event can be accessed from The National Press Club audio/transcript archive.