Antibiotic Misuse and Overuse

Which do you think is the greatest threat?

1. Overpopulation
2. War (including nuclear war)
3. Terrorism
4. Starvation
5. Climate change
6. Antibiotic overuse and misuse

The editors of the Washington Post remark on the threat of antibiotic resistance:

THE CENTERS for Disease Control and Prevention has published a disturbing new report on antibiotic resistance, the first since its benchmark survey in 2013. Antibiotic resistance is the tendency of pathogens — bacteria and fungi — to fight back against antibiotic drugs, making some infections harder to treat, or untreatable altogether, one of the most severe public health threats in the world today. The CDC’s report offers a glimmer of hope that resistance can be slowed, but it also shows how the dangers are deepening and changing, including with a new pathogen that wasn’t even on the radar screen six years ago.

Antibiotics, the miracle drugs invented in the mid-20th century, have made possible a revolution in modern medicine — for example, enabling organ transplants — and have spared countless individuals from death and illness. When bacteria became resistant in the early years, new antibiotics were readily created. But more recently, the pipeline of antibiotic development has slowed, and patients are again confronting untreatable illnesses.

The CDC knew this when it estimated in 2013 that 2 million Americans had suffered antibiotic-resistant infections resulting in 23,000 deaths a year. But using improved data methods, the CDC has now revised the estimates to 2.6 million infections then, and 44,000 deaths, nearly twice as many as thought. Today, the agency says there are 2.8 million infections and 35,000 deaths a year. The number of deaths due to antibiotic-resistant infections has dropped by 18 percent, according to the CDC, largely because of successful interventions by hospitals.

More and more bacteria are becoming resistant to existing antibiotics even as the pace at which new antibiotics are developed slows. The time may come when discovering a new antibiotic may be very rare.

I think the answer to my question is F. To understand why you need only reflect on what life was like a century ago. Surgery was frequently a death sentence due to infection. Many diseases that are readily treated today were frequently fatal in the past. Death in childbirth was much more common, frequently from sepsis. In my own family my maternal grandmother had four siblings. Three of them died before reaching the age of 30 of diseases readily treated with antibiotics. My father had three uncles. One of them died in his 20s of a disease treated today with antibiotics. One of the reasons the flu pandemic of 1918 killed so many people was bacterial superinfection for which there were no treatments. Life today would be tremendously different in a world without antibiotics.

Among the causes of antibiotic resistance are antibiotic misuse and overuse. In many of the countries of the world antibiotics are routinely sold over the counter including Mexico, Brazil, China, India, Indonesia, Pakistan, and Nigeria. Overuse of prescribed antibiotics is commonplace in the developed world. Here in the United States the CDC claims that 30% of prescriptions for antibiotics are unnecessary.

Overpopulation, starvation, and war are all possibilities. Antibiotic resistance due to the overuse and misuse of antibiotics is already here, getting worse, and is a threat that doesn’t heed borders, ethnicity, income, or social class.