The overprescribing of antibiotics, both in and out of hospitals, runs the risk of promoting the colonization of dangerous antibiotic-resistant microorganisms commonly known as “superbugs.” According to the Infectious Diseases Society of America, antibiotic resistant infections affect more than two million Americans per year, killing over 23,000. The Center for Disease Control (CDC), in its monthly report, Vital Signs, discusses the modern prevalence of drug-resistant bacteria and offers guidelines for the prudent use of antibiotics.
Antibiotics, now a mainstay of modern medicine and practically a household word, saw its first applications in the 1940s, after Howard Florey and Ernst Chain developed the manufacturing process for Penicillin, discovered by Alexander Fleming in 1942, when he observed that the mold killed colonies of the Bacterium Staphylococcus aureus. Since that time, researchers have developed hundreds of antibiotics, and their number continues to climb today. In its report, the CDC observes that “more than half of all hospital patients receive an antibiotic” and that “doctors in some hospitals prescribed 3 times as many antibiotics as doctors in other hospitals”.
The practical beauty of antibiotics lie in their ability to destroy bacteria that cause infections; some mild, some severe, and some deadly. Such infections include urinary tract and bladder infections, strep throat, skin and wound infections, and some sinus and ear infections. Severe and deadly infections responsive to antibiotic therapy include bacterial meningitis, tuberculosis, and some types of pneumonia.
However, in the miniscule and rapidly changing microsphere, a small number of microorganisms that contain mutant antibiotic-resistant genes can quickly multiply and infect its host with a new, and potentially dangerous, disease born of superbugs, which now requires an even stronger antibiotic to vanquish. It’s not so difficult to imagine how such a scenario might potentially spiral out of control.
The more recognizable names of these drug-resistant organisms include methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C-diff). MRSA initially made its appearance in hospitals in the 1960s, first in England, then in the US. MRSA can cause difficult-to-treat infections in wounds, the respiratory tract, and the urinary tract. This organism was once limited to patients in hospitals but eventually made its way into the community at large. C-diff is certainly one of the more serious superbugs. This organism resides naturally in the large intestine but remains harmless as other native bacteria keep its population in check. It is when antibiotics kill these controlling species of bacteria that C-diff begins to disproportionately multiply to fill the vacuum. This organism causes severe and potentially deadly colitis.
So what can be done to contain the spread of antibiotic-resistant organisms? The CDC offers ideas at all levels, including government (federal, state, and local), hospital, doctor, and patient. One theme that seems to predominate at more than one level is idea of adopting an antibiotic stewardship program that tracks the use of antibiotics and the patients for whom they are prescribed. Doctors are encouraged to obtain the proper cultures in order to identify the need for an antibiotic rather than preemptively prescribing one.
The CDC also recommends that patients be better educated in the uses of antibiotics. This type of education would include teaching that antibiotics cannot treat viral infections such as common colds or the flu. Patients should also be instructed to be sure that they finish their entire course of antibiotic therapy rather than stopping when they begin to feel better, which is usually only part of the way through.
Through these and other recommendations, the CDC hopes to curb the misuse of antibiotic therapy and reign in the spread of superbugs.
By Robert Wisnewski