World Faces Global Pandemic Of Antibiotic Resistance, Experts Warn

Sep. 18, 2008) — Vital components of modern medicine such as major surgery, organ transplantation, and cancer chemotherapy will be threatened if antibiotic resistance is not tackled urgently, warn experts on bmj.com.

A concerted global response is needed to address rising rates of bacterial resistance caused by the use and abuse of antibiotics or "we will return to the pre-antibiotic era", write Professor Otto Cars and colleagues in an editorial.

All antibiotic use "uses up" some of the effectiveness of that antibiotic, diminishing the ability to use it in the future, write the authors, and antibiotics can no longer be considered as a renewable source.

They point out that existing antibiotics are losing their effect at an alarming pace, while the development of new antibiotics is declining. More than a dozen new classes of antibiotics were developed between 1930 and 1970, but only two new classes have been developed since then.

According to the European Centre for Disease Prevention and Control, the most important disease threat in Europe is from micro-organisms that have become resistant to antibiotics. As far back as 2000, the World Health Organisation was calling for a massive effort to address the problem of antimicrobial resistance to prevent the "health catastrophe of tomorrow".

So why has so little been done to address the problem of resistance, ask the authors?

Antibiotics are over prescribed, still illegally sold over the counter in some EU countries, and self medication with leftover medicines is commonplace.

There are alarming reports about serious consequences of antibiotic resistance from all around the world. However, there is still a dearth of data on the magnitude and burden of antibiotic resistance, or its economic impact on individuals, health care, and society. This, they suggest, may explain why there has been little response to this public health threat from politicians, public health workers, and consumers.

In addition, there are significant scientific challenges but few incentives to developing new antibiotics, state the authors.

The authors believe that priority must be given to the most urgently needed antibiotics and incentives given for developing antibacterials with new mechanisms of action. In addition, "the use of new antibiotics must be safeguarded by regulations and practices that ensure rational use, to avoid repeating the mistakes we have made by overusing the old ones", they say.

They point out that reducing consumer demand could be the strongest force to driving change—individuals must be educated to understand that their choice to use an antibiotic will affect the possibility of effectively treating bacterial infections in other people.

But, they claim, the ultimate responsibility for coordination and resources rests with national governments, WHO and other international stakeholders.

Not only is there an urgent need for up-to-date information on the level of antibiotic resistance, but also for evidence of effective interventions for the prevention and control of antibiotic resistance at national and local levels, while more focus is needed on infectious diseases, they conclude.


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Adapted from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.
Source: ScienceDaily

Banning antimicrobials not effective, study says

A team of University of Georgia scientists suggest that curbing the use of antimicrobials on poultry farms will do little to reduce rates of infection with antimicrobial-resistant bacteria that have the potential to threaten human health.
Dr. Margie Lee, professor at the UGA College of Veterinary Medicine, and her colleagues have found that chickens raised on antimicrobial-free farms, and even those raised under pristine laboratory conditions, have high concentrations of bacteria that are resistant to common antimicrobials. Her findings, published in the March issue of the journal Applied and Environmental Microbiology, suggest that poultry come to the farm harboring resistant bacteria, possibly acquired as they were developing in their eggs.
The study was funded by grants from the Food and Drug Administration and the Department of Agriculture.
"This issue of antibiotic resistance is more complicated than once thought," Dr. Lee said. "These findings suggest that banning antibiotics at the farm level may not be as effective as assumed. We need further studies to identify which management practice would be effective."
The concern over the emergence of microbes resistant to antimicrobials that are used to treat human and animal infections led the European Union to ban the marketing and use of antimicrobials as growth promoters in animal feed. The final step in the phaseout was completed in January 2006.
In the United States, the Food and Drug Administration announced in July 2005 that it would ban the distribution or use of the antimicrobial enrofloxacin for poultry, which was marketed by Bayer Corporation under the name Baytril 3.23% Concentrate Antimicrobial Solution. The FDA said enrofloxacin caused resistance in Campylobacter jejuni when used to treat respiratory infections in poultry.
"They banned Baytril in 2005, and if you look at Baytril resistance in Campylobacter now, it's essentially unchanged," Dr. Lee said.
Currently, Congress is considering legislation to reduce routine use of antimicrobials in animal agriculture. The Preservation of Antibiotics for Medical Treatment Act (S. 549/H.R. 962) would phase out the use of certain antimicrobial drugs in food-producing animals for nontherapeutic purposes such as growth promotion, feed efficiency, weight gain, routine disease prevention, and other routine uses. Turn to page 976 in the April 1 issue of JAVMA News to learn why the AVMA has not supported passage of the legislation in the past.