Before the discovery of antibiotics in the 1940s, millions of people died from routine staph infections and more serious bacterial infections like meningitis, pneumonia and tuberculosis.
Sixty-three thousand Americans die each year from drug-resistant infections they get in hospitals. Antibiotic resistance is not a new problem, but what is troubling is that the number of drug-resistant bacteria is growing at the same time that the drugs used to combat them are decreasing in number and potency.
A new report published by the research policy institute Resources for the Future, in collaboration with scientists from the University of Chicago, Emory University and the National Institutes of Health, assesses the growing public health problem and what to do about it. "Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance" explores alternatives to help preserve these life-saving drugs.
Co-author Ramanan Laxminarayan says antibiotics must be valued as "societal resources," much like clean air or safe drinking water. "We have to find a way to manage antibiotics sustainably because everything in modern medicine depends fundamentally on the availability of antibiotics."
The report calls for new strategies to reduce demand for the drugs and buildup new supplies.
On the demand side, this means encouraging doctors to prescribe antibiotics only when absolutely necessary and for patients to use the drugs appropriately. Taking too small a dose of an antibiotic or using it for too short a time allows the targeted bacteria to develop mutations or to acquire drug resistance from other bacteria.
The report also calls for strict controls to reduce the most common hospital-acquired antibiotic-resistant infection: Methicillin- Resistant Staphylococcus Aureus or MRSA.
Laxminarayan says so-called 'search and destroy' measures adopted a decade ago by all Dutch hospitals have greatly reduced MRSA infections in the Netherlands. "They made sure that every new patient was not colonized with MRSA and if they were, they would keep them in isolation and treat them until they were cured and that is what they decided to do."
On the supply side of the antibiotics problem, the report recommends tax incentives to support development of truly novel antibiotics and a vaccine against MRSA. It also calls for expanding vaccination against pneumococcal bacteria. The report says these measures would help delay the emergence and spread of infections.
The report also recommends coordinated government action that would go beyond the interagency task force currently charged with addressing the problem.
Laxminarayan hopes the study will raise awareness among consumers and public officials about the need to preserve the effectiveness of modern antibiotics, and how to go about doing that before the health crisis gets any worse.
