Addressing the Antibiotic Resistance Crisis

Antibiotic-resistant infections cost the healthcare system more than $20 billion annually and result in more than 8 million additional days in the hospital. Overcoming the crisis will require comprehensive, multipronged strategies that are aimed at reducing the emergence and spread of antimicrobial-resistant organisms. Few New Antibiotics on the Horizon Many pharmaceutical companies have had less interest in developing new antibiotics because they aren’t as profitable as drugs used to treat chronic conditions or lifestyle issues. Additional barriers include uncertainties about requirements for FDA approval and the scientific and technical challenges that are inherent in identifying new classes of antibiotics. Once a successful new antibiotic clears hurdles and enters the market, the profitability of the drug is limited by effective antimicrobial stewardship programs and by the ability of microbes to rapidly adapt to antibiotics. Since 2008, only two new antibiotics have been approved by the FDA. “As much as 50% of antibiotic use in humans is either unnecessary or inappropriate.” The Infectious Diseases Society of America set forth the 10 x ‘20 Initiative to spur the development of 10 new antibiotics by 2020, a goal that includes new incentives for drug research and development, among other strategies. Unfortunately, little progress has been made in achieving this goal. Accordingly, legislators need to support new incentives for industry, and regulators need to consider the important clinical and public health benefits that antibiotics provide as they develop new guidelines and update existing guidance for the design of clinical trials. Education on Antibiotic Use is Critical As much as 50% of antibiotic use in humans is either unnecessary or inappropriate. Efforts to increase education...
New Superbug Surfaces in Three States

New Superbug Surfaces in Three States

An alarming new adaptable gene that can turn several common germs and types of bacteria into superbugs, resistant to almost all antibiotics, has infected people in the United States — California, Massachusetts, and Illinois. Originating in India, the superbug is thought to evolve due to the overuse and incorrect use of antibiotics — encouraged by over-the-counter sales of antibiotics in South Asia. Each of the patients that was infected had been to India prior to their arrival to the United States and has been effectively isolated and treated. However, there continues to be cause for concern that this superbug will spread in the U.S. When most people hear the word “superbug,” they think of MRSA, a bacterial infection highly resistant to some antibiotics that has been found in hospitals for years, but MRSA can be treated. The new superbug, however, has acquired a gene (NDM-1) that renders it resistant to almost all antibiotics. The bacteria first attack the digestive system and then enter the blood stream, potentially causing multiple organ failure. At this time, the most effective way to control the spread of these new drug-resistant bacteria is to diagnose it and quickly isolate the patient. Physicians should maintain heightened awareness in patients who have recently traveled to India or Pakistan. The CDC advises any hospitals that find such cases to put the patient in medical isolation, check the patient’s close contacts for possible infection, and look for more infections in the hospital. If you have encountered this new superbug in your practice we would welcome comments...