CDC Sounds Alarm on Antibiotic Resistance

September 17, 2013

News Review From Harvard Medical School -- CDC Sounds Alarm on Antibiotic Resistance

Drug-resistant bacteria cause at least 23,000 deaths in the United States each year. They infect more than 2 million people every year. And a focused campaign is needed to keep antibiotic resistance from wiping out our ability to cure infectious disease, U.S. health officials say. The Centers for Disease Control and Prevention (CDC) launched that campaign with a report and news conference. Officials listed 3 types of bacteria as an "urgent" threat and others as less urgent but still worrisome. The report outlines how antibiotic resistance has increased the risks of dialysis, cancer treatment and surgery. Excess use of antibiotics is the main cause. Up to half of the antibiotics prescribed in the United States are not necessary, the report said. It also called for an end to the use of antibiotics to promote growth of livestock. The CDC officials described a 4-pronged strategy to fight antibiotic resistance. One tactic will be to prevent both infections and the spread of resistance. Officials will help track resistant bacteria here and around the world. They also will push for wiser use of antibiotics and development of new ones. HealthDay News wrote about the campaign September 16. 

By Lori Wiviott Tishler, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

If we don't act now, our medicine cabinet will be empty and we won't have the antibiotics we need to save lives.

Tom Frieden, M.D.
Director, U.S. Centers for Disease Control and Prevention (CDC)

Those are some very strong words from the director of the CDC. Like many doctors and citizens around the country, I am more than dimly aware of the risks of antibiotics. Still, Dr. Frieden's words grabbed my attention. The CDC report and press release focused on the very real dangers of antibiotic resistance.

What is antibiotic resistance? Here is a simple example. If you get a strep throat, then the penicillin will kill off most of the strep. A few strep might survive. These survivors are, for many different reasons, resistant to the medicine -- for example, penicillin.  Next time, maybe the strep throat won't respond to penicillin.

People can acquire drug-resistant bacteria in many different ways. They can come from eating meat treated with antibiotics or from other people -- even, unfortunately, from health care professionals.

Why is antibiotic resistance a problem? The major issue is that antibiotics will be less able to treat common infections. The CDC estimates that more than 2 million illnesses and at least 23,000 deaths each year are related to antibiotic resistance. This would likely rank antibiotic resistance in the CDC's top 15 causes of death!

In its new report, the CDC ranked the resistance of three types of bacteria as urgent hazards:

• Clostridium difficile -- These bacteria can cause severe diarrhea, especially in the elderly and people who have serious illnesses.
• Enterobacteriaceae -- These bacteria from the digestive tract can cause invasive infections in the urinary tract and elsewhere.
• Neisseria gonorrhoeae -- These bacteria cause gonorrhea, a sexually transmitted infection.

Many other bacteria were listed as "serious" or "concerning" threats. They included some very common bacteria that cause pneumonia and strep throat. Fungi that cause some common yeast infections also made the "serious" list.

The CDC also revealed a four-pronged approach to monitor and address the problem:

• Prevent infections. Use vaccines, safe food preparation and hand washing.
• Track infections. Data gathered by the CDC can help health care organizations around the world to understand and better prevent these infections.
• Improve antibiotic use. Help doctors, farmers and the public to avoid use of antibiotics, in people and animals, unless they are needed.
• Continue to develop drugs and diagnostic tests. We can reduce, but probably not fully stop, the development of resistance. That means we must work to keep ahead of it with research and development.

The CDC's data are compelling, worrisome and real.  Humans are simply not keeping up with evolving bacteria. This puts more and more people at risk every single year -- inside and outside of the hospital, sick or well. It's terrifying to think of going backward in our ability to treat common infections.

What Changes Can I Make Now?

We can all help to decrease the impact and the growth of antibiotic resistance.  Here are some ways you can help:

• Get Smart. This is the CDC's campaign to decrease excess use of antibiotics. Know when antibiotics do and don't work. Don't demand antibiotics from your doctor.  Ask whether they will make a difference for your symptoms.
• Prevent infections. You can do this with great hand washing (with regular, not antibacterial, soap). Other hygiene measures also are important. For example, sneeze into your elbow, not your hand. Hospitals can reduce risk with thoughtful infection control measures and programs.
• Stay up to date with your vaccinations. A pneumococcal vaccine may actually help to decrease resistance in this very common type of bacteria.
• Practice safe sex. Use condoms to help prevent the spread of sexually transmitted diseases.
• Learn more about the antibiotics used in our food chain. These drugs also can increase antibiotic resistance. Make informed decisions about the food you are buying.

Don't panic or lock yourself and your family in the house.  Ask questions. Save antibiotics for when you really need them. 

What Can I Expect Looking to the Future?

I hope that this important report is the beginning of a serious campaign against antibiotic resistance. If these ideas work, then we may see decreased resistance and infections. If they don't, then we're heading down a worrisome path in our ability to confront serious, life-threatening infections.