Every year, more than 2 million people in the U.S. contract antibiotic-resistant infections, and at least 23,000 people die as a result, according to a new report issued by the CDC.
The report, Antibiotic Resistance Threats in the United States, 2013, presents what the CDC said is the first snapshot of the burden and threats posed by antibiotic-resistant germs having the most impact on human health. The threats are ranked in the categories of urgent, serious and concerning.
Threats were assessed according to seven factors associated with resistant infections: health impact, economic impact, prevalence, a 10-year projection of future prevalence, how easily the antibiotic-resistant pathogen spreads, availability of effective antibiotics and barriers to prevention.
Infections classified as urgent threats include carbapenem-resistant Enterobacteriaceae, drug-resistant gonorrhea and Clostridium difficile, which causes about 250,000 hospitalizations and at least 14,000 deaths every year in the U.S.
Antibiotic resistance is rising for many different pathogens that are threats to health, CDC Director Tom Frieden, MD, MPH, said in a news release. If we dont act now, our medicine cabinet will be empty and we wont have the antibiotics we need to save lives.
In addition to the toll on human life, antibiotic-resistant infections add considerable and avoidable costs to the already overburdened U.S. healthcare system, according to the CDC. Studies have estimated that antibiotic resistance adds $20 billion in excess direct healthcare costs in the U.S., with additional costs to society for lost productivity as high as $35 billion a year.
The use of antibiotics is the single most important factor leading to antibiotic resistance. Up to 50% of all the antibiotics prescribed for people are not needed or are not prescribed appropriately, according to the CDC.
Antibiotics also are commonly used in food-producing animals to prevent, control and treat disease, and to promote growth. As in humans, using antibiotics responsibly in animals is important, according to the CDC. To help ensure that medically important antibiotics are used judiciously in food-producing animals, the Food and Drug Administration recently proposed guidance describing a pathway for using these drugs only when medically necessary and targeting their use to address diseases and health problems.
Every time antibiotics are used in any setting, bacteria evolve by developing resistance, said Steve Solomon, MD, director of the CDCs Office of Antimicrobial Resistance. These drugs are a precious, limited resource. The more we use antibiotics today, the less likely we are to have effective antibiotics tomorrow.
The loss of effective antibiotic treatments also will undermine treatment of infectious complications in patients with other diseases, according to the CDC. Medical advances such as joint replacements, organ transplants, cancer therapy and rheumatoid arthritis therapy are dependent on the ability to fight infections with antibiotics. If the ability to effectively treat those infections is lost, the ability to safely offer people many of the life-saving and life-improving modern medical advances will be lost with it.
Searching for solutions
The CDC has identified four core actions critical to halting antibiotic resistance.
Preventing infections: Avoiding infections reduces the amount of antibiotics that have to be used and reduces the likelihood that resistance will develop. Drug-resistant infections can be prevented by immunization, infection prevention actions in healthcare settings, safe food preparation and handling, and general hand-washing.
Tracking: The CDC gathers data on antibiotic-resistant infections, causes of infections and whether there are particular risk factors for resistant infections. With that information, experts can develop strategies to prevent those infections and prevent the resistant bacteria from spreading.
Antibiotic stewardship: Perhaps the most important action needed to greatly slow the development and spread of antibiotic-resistant infections is to change the way antibiotics are used, according to the CDC. Up to half of antibiotic use in humans and much of its use in animals is unnecessary, the report authors stated. Providers should commit to always use antibiotics appropriately and safely only when they are needed to treat disease and to choose the right antibiotics and to administer them in the right way in every case.
Drugs and diagnostic tests: Because antibiotic resistance occurs as part of a natural process in which bacteria evolve, it can be slowed but not completely stopped. Therefore, new antibiotics always will be needed to keep up with resistant bacteria, as will new tests to track the development of resistance.