With the threat of running out of usable antibiotics looming, drug companies must be working overtime to save civilization from plunging back into the pre-antibiotic era, a time when a simple infection could prove fatal. “There are only about a handful of drugs being developed,” explains Henry Chambers, MD, professor of medicine at the University of California–San Francisco. “If you start out today with a program of 10 drugs, you’ll be lucky to get two or three onto the market. And it takes about 10 years to do that.” Translation? We need to get moving. Dr. Chambers also chairs the Infectious Diseases Society of America’s (IDSA’s) Joint Committee on the Prevention of Antimicrobial Resistance. In 2010, the organization launched its “10 x ‘20 Initiative” urging the creation of 10 new antibiotics in the next decade. But a new report published in the journal Clinical Infectious Diseases found we’re nowhere near being on track to deal with the barrage of antibiotic-resistant infections, illnesses from hard-to-kill superbugs for which we have dangerously limited treatment options. Adding urgency to the matter is the U.S. Centers for Disease Control and Prevention’s recently warning of the rise in carbapenem-resistant enterobacteriaceae (CRE) bacteria, the so-called “nightmare bacteria” that can kill up to half of the hospitalized patients they infect. The dangerous bacteria are largely contained to healthcare settings, but the worry is they will trade their resistance genes with other bacteria within the family, a trait that has helped bacteria successfully evolve and survive for eons. “Bacteria are much smarter than people,” explains Helen Boucher, MD, associate professor of medicine and program director of the Infectious Diseases Fellowship Program at Tufts University. “They can evade anything we do very quickly.” With that in mind, it should come as no surprise to hear that bacteria are outsmarting our drugs. But this resistance is accelerated as doctors hand out antibiotics to people who don’t have bacterial infections, or to those whose infections are so minor that they don’t need antibiotic treatment. The food system plays a role, too. Both Drs. Boucher and Chambers acknowledge that the use of antibiotics added to food fed to industrial raised livestock encourages the creation of superbugs. According to the Food and Drug Administration, farm animals gulp down about 30 million pounds of antibiotics a year. This constant, low-dose barrage of drugs isn’t used to treat disease, but rather to fatten up the animals faster for better profits. Dr. Boucher says that, in addition to antibiotic stewardship—cutting unnecessary use in patients and farm animals—we need to develop a clear regulatory path to encourage drugmakers to develop these much-needed new antibiotics. This could even involve increasing the price of antibiotics. Right now, drugmakers place more emphasis in medicines people take for the long haul, things like statins and diabetes drugs. In essence, those conditions often make those who need them lifetime customers. Antibiotics, on the other hand, are relatively cheap and are generally used for only short periods of time. Increasing prices and offering tax breaks and clear regulations could give drug companies incentive to dive into researching and developing new antibiotics, a costly enterprise. “We’re losing ground because we are not developing new drugs in pace with superbugs’ ability to develop resistance to them. We’re on the precipice of returning to the dark days before antibiotics enabled safer surgery, chemotherapy, and the care of premature infants. We’re all at risk,” Dr. Boucher, IDSA member and lead author of the policy paper. Here’s how you can help save antibiotics: Don’t demand antibiotics. And if your doctor prescribes them, ask if you really need them, suggests Dr. Boucher. Bronchitis, cold, flu, and most sinus, sore throat, and inner ear infections are caused by viruses. Taking antibiotics will do nothing to help you heal and helps promote antibiotic resistance. Support drug-free food production. Organic standards ban the use of antibiotics outright, and Certified Humane and Animal Welfare Approved certification bans the use of antibiotics for growth promotion. In other words, farmers who earn these certifications only use the drugs if an animal is sick and needs them. Protect yourself in healthcare settings. Ask any doctor or nurse touching you to wash his or her hands. Seek treatment at facilities that work under infection-control bundles, checklist guidelines that have been proven to reduce the rate of infection. Share your stories. Have you been affected by a superbug infection? Let your state and federally elected officials know about it. Dr. Boucher says hearing impact stories from families could help motivate politicians to tackle the problem of antibiotic resistance.
