Thursday, September 19, 2013

Super-Bugs Kill Thousands

The CDC report that drug resistant bacteria cause over two million illnesses and result in over twenty thousand deaths per year in the US is very troubling, especially since much of this is preventable. The recent increasing prevalence of carbapenem-resistant enterobacteriaceae (CRE) is truly frightening since the penems are the drugs of last resort in many cases. There are many reasons for the increasing frequency of resistant strains of bacteria, but two of the major contributions could readily be avoided. First, and foremost is the overuse of antibiotics in agriculture. The CDC has traced numerous examples of resistant bacteria to livestock that have been maintained on antibiotics to promote growth. There is increased public awareness of this, accompanied by demand for antibiotic free meats and dairy products. However, the overwhelming proportion of commercial livestock production in this country still relies on antibiotics. A second key contribution is inappropriate use of antibiotics by physicians. Many common illnesses have a viral causation and are thus unaffected by antibiotics. However, many patients demand antibiotic treatment for common respiratory and intestinal diseases even if it is not medically warranted, and physicians tend to acquiesce. More rapid gene-based tests to distinguish viral and bacterial diseases should help to alleviate this problem. In the meantime there is an urgent need for new antibiotics that will kill bugs that have become resistant to older drugs. Unfortunately the pharmaceutical industry is not investing in this area because of the relatively poor profit picture in the antibiotics field.  

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