-Causes?
Antibiotic resistance in bacteria happens when a given antibiotic can no effectively kill or stop the growth of a certain strain of bacteria. Antibiotic resistance occurs when someone takes an antibiotic and the bacteria that are resistant to the given antibiotic survive. Essentially the antibiotic exerts a selective pressure on the bacteria, promoting the growth of the strongest or most resistant strain of bacteria. Bacteria typically obtain resistance via a genetic mutation or get the resistance from another bacterium.
-Increasing rates of use and increasing resistance
Often times patients demand antibiotics when they are sick with the common cold without realizing that an antibiotic would have absolutely no positive impact on their viral infection. In addition, patients often do not follow the instructions on their prescription and may discontinue an antibiotic as soon as they start feeling better. This increases the likelihood that the patient will harbor an antibiotic resistant strain.
-Cost of Antibiotics
Antibiotic resistant strains of bacteria require the use of extensive treatments as well as stronger antibiotics such as Levaquin. Despite being available as a generic, the cost of generic Levaquin, Levofloxacin, is exceedingly high even with prescription coverage. This puts a significant financial burden on our healthcare system. Tufts University estimates that the total cost of Antibiotic resistant infections is in the range of 20 billion dollars without considering the corresponding societal costs of missed work and lowered productivity.
-Why should we care?
Do you ever want to get a fecal transplant? I didn't think so.
Antibiotic resistance is an area of increasing concern because infections that were once curable with a simple course of antibiotics are requiring much more extensive course to stop the infection. This is especially problematic in young children and the elderly.
-What should be done?
Many of the ways to help curb antibiotic resistance rely heavily on the patient taking the antibiotic. Patients should be sure to follow the instructions on their prescription exactly and not take left over antibiotics when they start feeling sick. Another key point is that antibiotics should not be prescribed for viral infections.
References
http://www.tufts.edu/med/apua/about_issue/about_antibioticres.shtml
http://www.rxlist.com/antibiotic_resistance-page2/drugs-condition.htm#concern
http://www.tufts.edu/med/apua/consumers/personal_home_5_1451036133.pdf
As someone who has taken many an antibiotic in my day I understand why this is such a problem. Even between different parts of the world there are varying degrees of antibiotic resistance to different drugs. For example in SE Asia Cipro still is an effective treatment, however in Africa grams of Cipro prove ineffective against basic ailments. I wonder how it is that we can spurn development of new antibiotics. Being that patients take them for a relatively brief time and their effective market life is short one can understand why pharm companies are not eager to spend billions of dollars developing new classes of drugs. This is where incentivisation by governments could create profitable space for companies that develop new antibiotics.
ReplyDeleteAntibiotic resistance is one of the biggest concerns we would have to deal with as health care providers. The dysregulated antibiotic use had created the super bacteria, and it is still quite problematic to deal with. Is it feasible to kill specific species of bacteria only? There are many good mutualistic microbes in our body system, and I am curious how far the pharmaceutical industries have been advanced to specifically deal with these organisms.
ReplyDeleteThank you for your posting, Charlie.
Best,
Minwoo
I agree with Charlie that antibiotic resistance puts a huge cost burden on the healthcare system and that patient compliance is one way to combat resistance. I have been researching MRSA for the thesis project and to answer Minwoo’s question, yes there are new treatments being developed, besides novel antibiotics, which can specifically target certain bacteria. One is an enzyme derived from bacteriophages, called Staphefekt, which can kill only Staphylococcus aureus, methicillin-sensitive and resistant strains.
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