Better coordination is needed to ensure that antibiotics remain effective in treating common infections, experts say.
By CAROLYNE KRUPA, amednews staff. Posted Nov. 26, 2012.
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Antibiotic resistance has been a growing health concern for decades. But 26 organizations are joining together to highlight the increasing urgency of the problem and protect the effectiveness of antibiotics for future generations.
The Centers for Disease Control and Prevention, American Academy of Pediatrics, Robert Wood Johnson Foundation and Center for Disease Dynamics, Economics & Policy are among the 26 organizations that announced the effort on Nov. 13. By signing a joint statement, the groups agreed to better coordinate efforts to fight antibiotic resistance, support related research, improve surveillance and raise awareness.
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“Antibiotic resistance has become one of the world’s most pressing health problems,” said Brian C. Quinn, PhD, senior program officer and team director of the Robert Wood Johnson Foundation’s Pioneer Portfolio, which is aimed at driving social change to improve health. “Antibiotics continue to be overused at alarming rates across the country. This problem is far too widespread to be handled alone.”
In conjunction with the statement, the CDDEP’s Extending the Cure project released its latest data about antibiotic use in different states. The five states with the highest rates of antibiotic use in 2010 were Kentucky, Louisiana, Mississippi, Tennessee and West Virginia. The states with the lowest use were Alaska, California, Hawaii, Oregon and Washington.
“The threat of antibiotic resistance returns again and again, and the threat of untreatable infections looms,” said Arjun Srinivasan, MD, associate director for Healthcare Associated Infection Prevention Programs with the CDC Division of Healthcare Quality Promotion. “There are patients in hospitals in this country that have infections that we cannot treat with any of the antibiotics that we have.”
Growing urgency
Antibiotic resistance is making some of the most common infections difficult to treat, said Clara Filice, MD, MPH, MHS, pediatric environmental health and food policy fellow with the AAP. A lot of the pathogens that cause infections — such as ear and skin infections — have become resistant to commonly used antibiotics.
“It is a growing public health crisis,” she said. “It’s something that most, if not all, physicians who are practicing are experiencing.”
More than 70% of bacteria that cause hospital-acquired infections are resistant to one or more antibiotics used to treat them, according to the National Institute of Allergies and Infectious Diseases.
Urinary tract infections are the second most common infection in the U.S., accounting for about 8.6 million patient visits annually, the CDC said. If they go untreated, UTIs can develop into serious bloodstream infections. But they are becoming harder to treat with the available arsenal of antibiotics, said CDDEP Director Ramanan Laxminarayan, PhD, MPH. Resistant bacteria that cause UTIs increased more than 30% between 1999 and 2010.
70% of bacteria that cause hospital-acquired infections are resistant to one or more antibiotics.
“These findings are especially disturbing because there are few new antibiotics to replace the ones that are becoming less effective,” he said. “New drug development needs to target the types of drug-resistant bacteria that cause these infections.”
There has been some progress. Overall, the percentage of antibiotic prescriptions filled nationwide has dropped 17% since 1999. Use of fluoroquinolones, which are commonly used to treat respiratory infections such as pneumonia, decreased 24% between 2007 and 2010. Deaths related to methicillin-resistant Staphylococcus aureus also have declined.
Health care professionals and organizations need to work together to improve antibiotic stewardship and reduce unnecessary use, Dr. Srinivasan said.
“It has reached a point of urgency,” said Henry “Chip” Chambers, MD, chair of the IDSA’s Antimicrobial Resistance Committee and chief of infectious diseases at San Francisco General Hospital. “We can’t invent ourselves out of this mess with new drugs. We are going to have to figure out how to save the ones we have.”
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