Preserving Antibiotics: Best Practices to Ward Off Superbugs

Failure to develop new antibiotics to combat the rising numbers of superbugs is contributing to the rise in infections worldwide, according to a report published today by a European researcher in the journal Lancet.

The paper comes at the heels of a surveillance report released today by the European Center for Disease Prevention and Control which found that rates of one type of drug-resistant bacteria have reached 50 percent in some European countries.

Overuse of antibiotics is to blame for the spread of drug-resistant bacteria, the report said.  But the problem is not limited to Europe, where programs and legislation has been developed in some countries to restrict inappropriate use of antibiotics. Every year, millions of Americans take antibiotics when they may not really need it.

“We’ve been shouting in the wind for years and Europe gets it,” said Dr. Brad Spellberg, associate professor of medicine at the Los Angeles Biomedical Institute at Harbor-UCLA Medical Center.   

Overuse and misuse of antibiotics can change germs, allowing them to develop resistance to antibiotics. But some bacteria have never responded to antibiotics to begin with.

 ”When we use a drug is we kill of the bacteria that are susceptible and leave behind the bacteria that is resistant so they can grow and spread,” he said.

“Antibiotic use does not cause antibiotic resistance,” said Spellberg, adding that antibiotic use only speeds the spread of resistance.

And the so-called “impeding catastrophe” –as described in the report released in the Lancet – of no new antibiotics to ward off these bugs suggests that many people may go on to develop potentially untreatable infections.

Antibiotics are only effective for certain bacterial infections. But almost daily, antibiotics are unnecessarily prescribed for respiratory infections like the common cold, sore throat, ear infections, and bronchitis.  

$1.1 billion is spent annually on unnecessary adult upper respiratory infection antibiotic prescriptions, according to the U.S. Centers for Disease Control and Infection.

Besides calling for restricting inappropriate use of antibiotics, experts should also research alternative ways to treat bacterial infections such as immunotherapy, look for vaccines to prevent infections, and develop tests to help physicians diagnose infections that will benefit from antibiotics.

The CDC announced November it will launch a nationwide tracking system that will let over 4000 hospitals see the amount of antibiotics it uses, compare its use to other hospitals, and potentially help hospitals better manage when it dispenses antibiotics.

But the majority of antibiotics are not used in a hospital or outpatient setting. Nearly 80 percent of antibiotics developed are used in livestock feed.

“We have to begin to think of antibiotics as a precious natural resource, the way we think of forests and fishery,” said Spellberg, who is also a member of the Infectious Disease Society of America’s Antimicrobial Availability Task Force.

Since the discovery of antibiotics less than a century ago, widespread use of the treatment has altered some bacteria causing it to develop new modes of defense.

“The nagging of physicians not to overprescribe has been going on for 60 years,” said Spellberg. “We need technology to overcome this, not nagging.”