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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