The Dark Side of Antibiotics

Why the CDC is advising hospitals to scale back on prescriptions.

National Journal
Brian Resnick
March 5, 2014, midnight

The Cen­ters for Dis­ease Con­trol and Pre­ven­tion wants hos­pit­als to is­sue few­er pre­scrip­tions for an­ti­bi­ot­ics. Why? Be­cause the drugs that are sup­posed to make people feel bet­ter are be­ing ab­used, ac­tu­ally caus­ing ill­ness, and hasten­ing the ar­rival of in­fec­tions for which medi­cine has no cure.

That’s not to say the CDC wants to cut the drugs from treat­ment en­tirely. A bac­teri­al in­fec­tion still re­quires an­ti­bi­ot­ics. Rather, the CDC wants to stifle the ap­prox­im­ately 30 per­cent to 50 per­cent of an­ti­bi­ot­ic treat­ments that the or­gan­iz­a­tion deems un­ne­ces­sary or in­ap­pro­pri­ate. The CDC also want doc­tors to make smarter dos­ing de­cisions when an­ti­bi­ot­ic use is ap­propi­ate. 

An­ti­bi­ot­ics can cause CDI (C. dif­fi­cile in­fec­tion), a diarrhea “that of­ten re­curs and can pro­gress to sepsis and death,” as the CDC re­port re­leased Tues­day reads. CDI oc­curs when an­ti­bi­ot­ics throw off the nat­ur­al bal­ance of healthy bac­teria in the di­gest­ive tract.

In the study, the CDC pre­dicted that de­creas­ing an­ti­bi­ot­ic use by 30 per­cent would lead to a 26 per­cent de­crease in CDI. By the CDC’s es­tim­ate, that would im­prove the out­comes of 65,000 people. Fur­ther­more, the cen­ter found that one in three pre­scrip­tions for ur­in­ary tract in­fec­tions con­tained a po­ten­tial er­ror (“giv­en without prop­er test­ing or eval­u­ation, or giv­en for too long”), and some hos­pit­als pre­scribe an­ti­bi­ot­ics at rates three times as high as oth­ers.

But those prob­lems seem small when you con­sider the loom­ing threat of the over­use of an­ti­bi­ot­ics — the rise in dis­eases that do not re­spond to the drugs at all.

As re­por­ted in Septem­ber, the CDC es­tim­ates that 23,000 people a year die of such dis­eases. And bar­ring in­nov­a­tion in phar­ma­ceut­ic­als (which is lag­ging far be­hind ad­vance­ments in oth­er cat­egor­ies of drugs) or re­duc­tion ef­forts as out­lined in this cur­rent re­port, that num­ber is likely to rise.

The CDC is head­ing up an ef­fort to bet­ter track the spread of an­ti­bi­ot­ic res­ist­ance, and the Obama ad­min­is­tra­tion’s 2015 budget provides $30 mil­lion over the next five years to set up re­gion­al labor­at­or­ies to mon­it­or out­breaks.

There’s an in­ev­it­ab­il­ity to drug-res­ist­ant bac­teria, even with new ad­vances in the sci­ence. “Nature will take its course wherever an­ti­bi­ot­ics are used,” Jean Pa­tel, a re­search­er in mi­cro­bi­al res­ist­ance at the CDC, told me in Septem­ber. 

But the phar­ma­ceut­ic­al in­dustry is not even pro­du­cing those new drugs that could buy some time.

As The At­lantic demon­strates in its March is­sue, ap­provals of new an­ti­bi­ot­ic drugs are at their low­est levels in 30 years.

(The At­lantic)

What We're Following See More »
TAKING A LONG VIEW TO SOUTHERN STATES
In Dropout Speech, Santorum Endorses Rubio
2 days ago
THE DETAILS

As expected after earlier reports on Wednesday, Rick Santorum ended his presidential bid. But less expected: he threw his support to Marco Rubio. After noting he spoke with Rubio the day before for an hour, he said, “Someone who has a real understanding of the threat of ISIS, real understanding of the threat of fundamentalist Islam, and has experience, one of the things I wanted was someone who has experience in this area, and that’s why we decided to support Marco Rubio.” It doesn’t figure to help Rubio much in New Hampshire, but the Santorum nod could pay dividends down the road in southern states.

Source:
‘PITTING PEOPLE AGAINST EACH OTHER’
Rubio, Trump Question Obama’s Mosque Visit
2 days ago
WHY WE CARE

President Obama’s decision to visit a mosque in Baltimore today was never going to be completely uncontroversial. And Donald Trump and Marco Rubio proved it. “Maybe he feels comfortable there,” Trump told interviewer Greta van Susteren on Fox News. “There are a lot of places he can go, and he chose a mosque.” And in New Hampshire, Rubio said of Obama, “Always pitting people against each other. Always. Look at today – he gave a speech at a mosque. Oh, you know, basically implying that America is discriminating against Muslims.”

Source:
THE TIME IS NOW, TED
Cruz Must Max Out on Evangelical Support through Early March
2 days ago
WHY WE CARE

For Ted Cruz, a strong showing in New Hampshire would be nice, but not necessary. That’s because evangelical voters only make up 21% of the Granite State’s population. “But from the February 20 South Carolina primary through March 15, there are nine states (South Carolina, Alabama, Arkansas, Georgia, Oklahoma, Tennessee, Kentucky, Mississippi, and North Carolina) with an estimated white-Evangelical percentage of the GOP electorate over 60 percent, and another four (Texas, Kansas, Louisiana, and Missouri) that come in over 50 percent.” But after that, he better be in the catbird’s seat, because only four smaller states remain with evangelical voter majorities.

Source:
CHRISTIE, BUSH TRYING TO TAKE HIM DOWN
Rubio Now Winning the ‘Endorsement Primary’
2 days ago
WHY WE CARE

Since his strong third-place finish in Iowa, Marco Rubio has won endorsement by two sitting senators and two congressmen, putting him in the lead for the first time of FiveThirtyEight‘s Endorsement Tracker. “Some politicians had put early support behind Jeb Bush — he had led [their] list since August — but since January the only new endorsement he has received was from former presidential candidate Sen. Lindsey Graham.” Meanwhile, the New York Times reports that fueled by resentment, “members of the Bush and Christie campaigns have communicated about their mutual desire to halt … Rubio’s rise in the polls.”

Source:
ARE YOU THE GATEKEEPER?
Sanders: Obama Is a Progressive
1 days ago
THE LATEST

“Do I think President Obama is a progressive? Yeah, I do,” said Bernie Sanders, in response to a direct question in tonight’s debate. “I think they’ve done a great job.” But Hillary Clinton wasn’t content to sit out the latest chapter in the great debate over the definition of progressivism. “In your definition, with you being the gatekeeper of progressivism, I don’t think anyone else fits that definition,” she told Sanders.

×