Vol. 14 •Issue 20 • Page 34
Experts Concerned About Antibiotic Resistance
Antibiotic resistance continues to creep into the community,” said Stuart B. Levy, MD, at a recent symposium of the National Foundation for Infectious Diseases in Washington, D.C., “despite the fact that health care professionals are finally beginning to understand the importance of the problem of resistance.”
Until recently, the community has been spared from the antibiotic resistance problem, which has long been focused primarily in hospitals, Dr. Levy said. “But it’s now in the community,” he noted.
One solution to the problem, Dr. Levy posited, is wider public awareness of the consequences of antibiotic overuse or inappropriate use.
The director of the Center for Adaptation Genetics and Drug Resistance and a professor of Molecular Biology and Microbiology at Tufts University School of Medicine, Boston, and author of The Antibiotic Paradox, pointed out a recent case of an 11-month-old child in Georgia with an ear infection. The pneumococcal infection was resistant to six different antibiotics.
“It’s Darwinism at its best,” Dr. Levy said. “Moreover, resistant bacteria move from one place to another, even among countries. Conceivably, in the future we could require people entering this country to have their bags and bodies undergo a sterilizing procedure to kill any organisms they might bring in.”
What Is Happening
Probably, the first clinical indication of resistance entering the community was the appearance of penicillin-resistant Haemophilus influenzae and Neisseria gonorrhoeae (the cause of gonorrhea) in the mid 1970s. Up to then, these respiratory and sexually transmitted disease agents were totally susceptible to penicillin and other commonly used antibiotics.
As more members of the community began to use antibiotics, bacteria involved in community infections emerged resistant to multiple different antibiotics. Dr. Levy used ciprofloxacin (Cipro“, Bayer Corp.) as an example of how antibiotics have been misused, describing “Cipromania.”
“During the anthrax scare [this past fall], the word was out that Cipro was a drug of choice against Bacillus anthracis,” he commented. “Rapidly, Cipro became available for sale on the Internet and people began stockpiling it by calling their physicians. Of course, most did not need it because they weren’t exposed to anthrax. More critically, my concern is that when they get a cold or the flu and see that bottle of Cipro in their medicine cabinet¾like that revered bottle of old wine¾that they don’t decide to just take it for that infection.” This is how antibiotic resistance occurs, he said, because it can be the wrong medicine for that illness or the patient does not take the full regimen in order to truly kill the bacteria, or the patient has a virus, for which an antibiotic is useless.
Overuse a Problem
The country is definitely on an antimicrobial campaign, Dr. Levy pointed out.
“I found Chinese chopsticks for sale that are impregnated with an antibacterial salitac,” he said. “There are antibacterial telephone pads and mattresses. It is a rage.”
Another possible cause of the resistance may be the use of antibiotics in animal husbandry. Sweden has banned the use of these products and its livestock is thriving. Dr. Levy commented it is clear that the use of antibiotics in agriculture has led to resistance of certain kinds of bacteria causing infections in humans, but the majority of resistance is caused by human misuse. x
Gail Guterl is editor of ADVANCE for Nurses in the Philadelphia tri-state area and in Maryland, Virginia and Washington, D.C.