Health Crisis: The Rising Impotence of Antibiotics
For the first time, the Centers for Disease Control is warning you could get an infection that even our most powerful drugs can't kill. There might not be a thing doctors can do if it happens to you.
For 70 years, we've relied more and more on antibiotics to fight infections -- so much that some bacteria have strengthened to the point that drugs can no longer kill them. An alarming CDC survey reported that these bacteria infect around 2 million Americans each year, killing 23,000 of them.
CDC Director Tom Frieden said if we don't turn things around, it will get even worse.
"Antibiotic resistance is one of the most serious health threats we face today," he said. "We risk entering a post-antibiotic era where even simple infections can be deadly."
At the top of the list is C-Diff, a bacterial infection that targets the intestinal tract and kills 14,000 people a year. That's followed by drug-resistant gonorrhea, an infection making up about one-third of the cases of this sexually transmitted disease. Then there's CRE, a respiratory bacteria infecting 9,000 hospital patients each year, killing half of them.
"I've called CRE a nightmare bacteria," Frieden explained. "It can resist all antibiotics, kill a high proportion of people it infects, and spread from person-to-person and bacteria-to-bacteria readily."
The CDC blames this resistance on the overuse of antibiotics, to the extent that half of the prescriptions given by doctors aren't even necessary.
Dr. Nancy Khardori agrees. As an infectious disease specialist with Eastern Virginia Medical School, she pointed out that antibiotics kill only infections that are bacterial, not viral.
However, most of the time when sick people go to their doctor's office, they have a viral infection and therefore, they don't need an antibiotic.
The problem is, there's no reliable way for doctors to instantly know whether an infection is viral or bacterial, so doctors tend to give all their sick patients antibiotics to help the few patients who actually need it.
"One of the things physicians worry about is, 'Okay, I didn't give them an antibiotic, they went home, next day they get really sick and they don't come back. And something bad happens,'" Khardori said.
Economics a Factor
Antibiotics aren't just overused in humans, they're also unnecessarily given to animals raised for food. In fact, animals receive 80 percent of all antibiotics, and much of that goes into their food.
"It's been found that if you give them antibiotics in their feed, which they don't need for infection, it makes them bigger, quicker," Dr. Khardori explained. "So they can be sold at the market quicker."
"So it's more of an economic issue than animal health issue," she said.
It becomes a health issue for humans when antibiotic resistant bacteria gets passed from animals to people. The Food and Drug Administration has asked livestock producers to voluntarily stop adding antibiotics to feed, but not many have complied.
Antibiotic overuse is only part of the problem. To make matters worse, drug companies aren't making many new antibiotics to replace the old ones that aren't working any more.
Drug companies need to make a profit, and these days there's not much money in antibiotics. As a result, only two new antibiotics have been developed in the last five years.
Compare that to the mid-1980s, when during a period of just four years drug companies developed 16 new antibiotics.
So while using antibiotics less and developing new ones slows down the spread of drug resistant infections, we can also better protect ourselves from getting them.
Hand washing, avoiding people with infections, and getting a good night's sleep go a long way.
Hospitals also need to reduce infection. Check with your state health department to see which hospitals have the lowest infection rate.
Dr. Gene Burke heads Sentara Healthcare, one of Virginia's top healthcare systems. He said patients can and should do their part to help reduce their chance of infection.
"Every patient should feel totally empowered to say to everyone who walks in the room, 'Have you washed your hands? Would you mind doing it now?' " he advised.
Many hospital infections strike at contact points where devices go into your body. So the sooner they are out, the better.
Burke described how to accomplish this.
"Talk to your care team," he said. "Help them know that you expect them to have the fewest number of things put into you that's necessary, and that you would like them, every single day, if you have a catheter or IV in, to answer the question, 'Is it still necessary today?'"
While antibiotic-resistant bacterial infections pose a critical health threat, the trend can be reversed.
"There are four things we have to do to protect antibiotics," Frieden said. "First, prevent infections and the spread of drug-resistant bacteria. Second, use antibiotics much more responsibly. Third, track resistance patterns. And fourth, develop new drugs."