The Dark Side of Antibiotics

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

National Journal

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)