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.
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