In a recent commentary published in the Journal of the American Medical Association, Dr. James M. Hughes, a world authority on infectious diseases at Emory University, sounded an ominous warning about the ever-increasing danger of infections that are resistant to most, if not all, available antibiotics.
Each year, these infections account for more than $20 billion in health care costs and more than 8 million additional and avoidable days stayed in the hospital. Not only is this an economic crisis, but it's also a national security threat. It's possible to engineer bacteria that are highly infective, which leads to widespread national epidemics of infections with no adequate therapy.
The treatment and cure of many serious diseases, such as cancer, is seriously compromised if there's an overwhelming infection resistant to all antibiotics. Just recently, a new strain of bacteria resistant to every known antibiotic is causing infections worldwide and becoming a global public health threat.
This problem is becoming more serious as the pipeline of development of new and more powerful antibiotics has slowed to a trickle. Between 1983 and 1987, Hughes said that the FDA approved 16 new antibiotics, compared with only two since 2008. The dearth of drug development is made worse by the withdrawal of most pharmaceutical companies from antibiotic research. These drugs work too quickly, and the profit margin is not as great as medications used to treat chronic diseases.
And because the drugs are used inappropriately, resistance to them develops rather quickly. There is such a crisis on the horizon that the major societies in infectious disease have issued an initiative that commits key leaders to identify 10 new, safe and highly effective antibiotics by 2020. This will require increased funding from Congress and by nations worldwide as well as strong leadership from the Food and Drug Administration to assist in appropriate testing and approval within a reasonable time frame.
Sadly, this crisis has been brought on by the health care community, which is too willing to prescribe antibiotics or choose the newest and most heavily marketed drugs over the tried-and-true older drugs, and by the general public, who have an insatiable demand for antibiotics for the treatment of virtually every malady. The evidence is compelling that more than 50 percent of prescriptions for antibiotics are unnecessary, of no value or inappropriate.
All of us harbor bacteria on our skin, nose, sinuses and gastrointestinal tract that are harmless, provide invaluable nutrients, and prevent the overgrowth of harmful bacteria that can cause serious disease. Prescribe a powerful antibiotic for a minor infection (that is often viral), and all the normal bacteria are killed off. A void is created that is replaced by other bacteria, which can lead to severe generalized infections, diarrhea and recurrent infections that are difficult to treat. And the older the patient, the greater the possibility of a significant problem.
Hughes points out the value of educating the health care community that the use of powerful antibiotics should not be the first-line approach to treating common infections. The evidence is compelling that bacterial resistance to antibiotics can be reduced by better use of antibiotics combined with controlling the spread of infections from patient to patient in hospitals and other health care facilities.
The public must develop an understanding that antibiotics do not miraculously cure all symptoms. Chronic coughs, colds, sore throats, diarrhea and nausea are usually caused by viruses. Sometimes coughs can reflect allergies, and even if viral, they can last quite a long time. Listen to the doctor who wishes to temporize before prescribing an antibiotic. If given too quickly, always ask if the drug is needed.
This is a serious problem that is reaching frightening proportions. And as we grow older and risks of serious diseases increase, the threat of antibiotic resistance becomes even more real.
Dr. David Lipschitz is the author of the books "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.
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