Sunday, March 27, 2011

Lifesaving Antibiotics Losing Power Due to Resistant Germs

 The single most important medicine ever discovered is the antibiotic.  Prior to 1930, humans died at early ages of simple infections and even childbirth was a major killer of women because of infection.   The mortality rate from simple staph aureus was as high as 80%,  but between 1944 and 1972 the human life expectancy jumped by 8 years because of antibiotics.   By 1950 the golden age of antibiotics was already looking tarnished as organisms became resistant to the drugs.  Now many medical advances that we take for granted, including cancer treatment, surgery, transplantation and neonatal care are endangered by increasing antibiotic resistance and a decline in new medications to combat the super germs.

Drug resistance is both a public health and global security threat. Resistance has emerged for all known antibiotics in use.  For most antibiotics, resistant genes have created super bugs that require more combinations of antibiotics  to treat and there are certain infections that we cannot effectively treat. 

Why are bacteria becoming resistant to antibiotics?  Every time a person takes antibiotics, sensitive bacteria are killed but resistant germs may be left to grow and multiply.  Exposure to antibiotics therefore provides selective pressure which makes the surviving bacteria more likely to be resistant as well as develop mutations of genetic material that code for resistant properties from other bacteria.

It is estimated that as much as 50% of antibiotic use in humans is either unnecessary or inappropriate.  Doctors call this "antibiotic stewardship" and it is important not to use "super" antibiotics when simple ones (or none at all) will work.  Also many food animals - poultry, chickens, pigs and cattle - are routinely treated with antibiotics in order to grow faster and compensate for unsanitary conditions on industrial farms.  It is estimated that between 30-70% of all antibiotics sold in the U.S. are used on farm animals.  The genetics of resistant bacteria in farm animals is exactly the same as humans.  The resistant bacteria can be spread to soil, well water, contaminated waste and even farm workers or food processors.

The development of new antibiotics has almost come to a standstill.  From 1983 to 1987, 16 new antibiotics were approved by the FDA.  From 2003 - 2007 just 5 were approved and since 2008 only 2 were approved.  Most pharmaceutical companies have withdrawn from market research and development because these drugs are not as profitable as those used to treat chronic conditions or lifestyle issues.

(Top $$ selling brands in 2009 were Lipitor, Plavix, Remicade, Advair, Enbrel, Avastin, Abilify, Rituxan, Humira, Diovan, Crestor, Lovenox - none are antibiotics and  all are used for chronic conditions.)

So what can we do?  First, understanding that antibiotics are precious medications that need to be preserved for serious infections is important.  Insisting on legislation that cleans up industrial farms and uses antibiotics on animals only to treat disease, not for growth or prevention is also critical.  Being aware that this is a problem is first and insisting on regulations follows.

And third, promoting financial incentives for drug research and development and funding increases for research on resistance and drugs to treat infections is a needed step.   The FDA should have priority regulatory review for applications for these types of products.

(JAMA, March 9, 2001, Vol 305, No 10)


Kathleen, MD said...

Great post about a super important topic. We all need to hear it over and over - patients AND docs.

The animal issue really gets me. It's frustrating to spend valuable time explaining to patients that they shouldn't have the antibiotic they are sure they need - and to know that up to 70% of antibiotic use (or rather misuse) is in animals. Their resistance spreads to us as you rightly mentioned.

3M respirators said...

This information is very essential for every human Being.people are using Antibiotics to fight against the infections.Because it will increase the immune power.And kill the bacteria and Viruses.Thank you for Sharing such an informative blog.

Zach Kirsch said...

'I have seen the enemy and he is us'. We physicians bear responsibility for overprescribing antibiotics for viruses and other self-limited illnesses. Sure, patients often want them, but our job is to educate, not just medicate.

Anonymous said...

Good one, Toni -
and here's one of my latest, written from the point of view of a bacterium:

Anonymous said...

I had a doctor that used to alternate using different antibiotics and look in my chart to see what the previous one was, which I always thought was for that reason, but never asked. I did not take them very oftern unless it was for a respiarotry infection.

Toni Brayer, MD said...

Anon 6:35PM: That strategy by your previous physician probably increased the antibiotic resistant organisms in your body. Not good medicine!

Anonymous said...

Dr.B, Thanks for letting me know that what my previous my precious physician did was "not good medicine"
I don't think this doctor knew anything was wrong with that strategy and meant well, which is a scary mistake.

Anonymous said...

Hi ,

Resistant Germs is very dangerous and there is a video talking about microbial and antibiotic resistance and how to prevent it ...

I think it is important .

here is it


Wabush said...

Thank-you for so much information! I have been reading all this stuff very carefully because I think it all links to much of what I have been researching. Blastospores in the air have become charged with neural particles, mostly from the Japan nuclear situation, and these fungus spores and zigospores are mutating and becoming way more resistant.
Feel free to explore my research site at

Keep up the good work - Wabush

muebles en pontevedra said...

This will not work as a matter of fact, that is what I believe.

When to Use Urgent Care

We all know that Emergency Departments are over-crowded with long waits and exorbitant fees.  Free standing Urgent Care is a great solu...