Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Antibiotics Losing The Battle Against Drug-Resistant Bacteria

The single most important medicine ever discovered is the antibiotic.  Prior to 1930, humans died at early ages of simple infections and even childbirth was a major killer of women because of infection.   The mortality rate from simple staph aureus was as high as 80%,  but between 1944 and 1972 the human life expectancy jumped by 8 years because of antibiotics.   By 1950 the golden age of antibiotics was already looking tarnished as organisms became resistant to the drugs.  Now many medical advances that we take for granted, including cancer treatment, surgery, transplantation and neonatal care are endangered by increasing antibiotic resistance and a decline in new medications to combat the super germs.

Drug resistance is both a public health and global security threat. Resistance has emerged for all known antibiotics in use.  For most antibiotics, resistant genes have created super bugs that require more combinations of antibiotics  to treat and there are certain infections that we cannot effectively treat.  

Why are bacteria becoming resistant to antibiotics?  Every time a person takes antibiotics, sensitive bacteria are killed but resistant germs may be left to grow and multiply.  Exposure to antibiotics therefore provides selective pressure which makes the surviving bacteria more likely to be resistant as well as develop mutations of genetic material that code for resistant properties from other bacteria.

It is estimated that as much as 50% of antibiotic use in humans is either unnecessary or inappropriate.  Doctors call this “antibiotic stewardship” and it is important not to use “super” antibiotics when simple ones (or none at all) will work.  Also many food animals – poultry, chickens, pigs and cattle – are routinely treated with antibiotics in order to grow faster and compensate for unsanitary conditions on industrial farms.  It is estimated that between 30-70% of all antibiotics sold in the U.S. are used on farm animals.  The genetics of resistant bacteria in farm animals is exactly the same as humans.  The resistant bacteria can be spread to soil, well water, contaminated waste and even farm workers or food processors.

The development of new antibiotics has almost come to a standstill.  From 1983 to 1987, 16 new antibiotics were approved by the FDA.  From 2003 – 2007 just 5 were approved and since 2008 only 2 were approved.  Most pharmaceutical companies have withdrawn from market research and development because these drugs are not as profitable as those used to treat chronic conditions or lifestyle issues.

(Top $ selling brands in 2009 were Lipitor, Plavix, Remicade, Advair, Enbrel, Avastin, Abilify, Rituxan, Humira, Diovan, Crestor, Lovenox – none are antibiotics and  all are used for chronic conditions.)

So what can we do?  First, understanding that antibiotics are precious medications that need to be preserved for serious infections is important.  Insisting on legislation that cleans up industrial farms and uses antibiotics on animals only to treat disease, not for growth or prevention is also critical.  Being aware that this is a problem is first and insisting on regulations follows.

And third, promoting financial incentives for drug research and development and funding increases for research on resistance and drugs to treat infections is a needed step.   The FDA should have priority regulatory review for applications for these types of products.

*This blog post was originally published at EverythingHealth*


You may also like these posts

Read comments »


Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »