The Rising Spread of Drug-Resistant Superbugs

Medically reviewed in January 2020

With a sinking stomach, I scrolled through my patient’s medical record, down the list of antibiotics that could do nothing to help her get well. Her infection was due to bacteria resistant to most of our antibiotics. Treating it would be challenging—if we could do it at all—and require a regimen of multiple antibiotics, each with their own side effects and interactions. I called the Infectious Disease physician for her input—for the third time that day. I’d had two other patients with similarly resistant medications in the past five hours.

How did we get here? When doctors began using penicillin to treat infections in the 1940s, it was hailed as a “miracle cure.” Before antibiotics, strep throat was fatal. A simple urinary tract infection (UTI) could spread and lead to organ failure. Patients died from infections after surgery. But no longer. Infections that had once been inevitably fatal, claiming thousands of lives, were now treatable.

The balance shifts
Then something changed. Doctors started to notice that some patients seemed to be resistant to penicillin. Fortunately, pharmaceutical companies were able to develop other, more comprehensive, stronger antibiotics that could kill bacteria. But things are changing once again. And while new antibiotics are part of the solution, resolving the problem isn’t that simple.

A global health crisis
How big is the problem? Big. And getting bigger. In the U.S., the Centers for Disease Control and Prevention (CDC) estimates that two million people become ill from resistant bacteria, and 23,000 die every year. It’s not just the U.S. and other developed countries, however. This is truly a global problem, especially in developing countries. In India, more than 58,000 infants died last year due to resistant infections. The World Health Organization (WHO) warns us of the possibility of entering into a “post-antibiotic era” in which our antibiotic regimens are ineffectual.

Why is this happening?
The causes are manifold. In developed countries they include:

  • Overuse of antibiotics
  • Advances in medicine that allow us to care for sicker and more immuno-compromised patients
  • Antibiotics pumped into some of our animal food sources, creating drug resistance in those animals. Some of those bacteria strains may get passed to humans.
  • Patients failing to complete a course of antibiotics (think of the times you may have stopped or forgot to finish an antibiotic once you were feeling better).

Developing countries seem to be the hotbeds of resistance for many diseases, including tuberculosis. In India, for example, widespread availability of antibiotics (they’re available over the counter); uncontrolled prescription by physicians (at some hospitals, every newborn is given antibiotics whether they need them or not); poor sanitation (50 percent of people in India do not have toilets); antibiotic use in livestock; and lack of antibiotic surveillance (many patients with tuberculosis fail to complete their treatment) have yielded extremely high rates of resistance.

In the U.S., medical association campaigns to decrease antibiotic use have been successful, significantly decreasing prescriptions in the past 10 years. In November 2013 the Obama administration created a taskforce to study the crisis. As part of an ongoing effort to address it, recommendations were made calling for improved surveillance of the rise of antibiotic-resistant bacteria; the development of new antibiotics by pharmaceutical companies; and increasing the shelf life of existing antibiotics by supporting efforts to curb their usage.

How you can help
We can all do our part to be better stewards of antibiotic use. I still have many patients who push for an antibiotic even when it’s not medically necessary. I become very concerned when I read a review of a clinic—online or in a health app—where every single patient says, “It was great, I was in and out in ten minutes with my antibiotic.” We all need to be more judicious, from patients to providers.

If you need an antibiotic, take it completely and as directed. I also make an effort to purchase foods that are antibiotic-free. Lastly, don’t forget to prevent infections in the first place by practicing good hand hygiene and getting vaccinations as recommended by your doctor. I don’t want to practice medicine in a post-antibiotic era and I wouldn’t want to be a patient in it, either. With significant, immediate efforts, we can work to prevent this from becoming a reality.

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