As Antibiotic-Resistance Grows, Treatment Becoming ‘More Complicated’

“Infection prevention methods and control of antibiotic use demonstrated an 18 percent reduction in mortality due to antimicrobial-resistant organisms between 2012 and 2017,” said Smith. “The U.S. lost ground combating antimicrobial resistance during the COVID pandemic.”

She explained that the setbacks were due to multiple factors, including the increased use of antibiotics at the beginning of the pandemic for pneumonia that was thought to be bacterial in origin.

Another issue was that the CDC and local departments of health that had been focusing on antimicrobial resistance were repurposed to deal with COVID.

“This dramatically accelerated vaccine development and implementation,” said Smith. “These efforts were remarkable but detracted from the fight against increasing antimicrobial resistance.”

The Era of Rapid Development Has Ended

“So we were able to ‘stay ahead’ of antibiotic resistance because we always had a new antibiotic that we could pull off the proverbial shelf and use,” he continued.

In those early days of drug development, the “easy” antibiotics were discovered, but we’re in a difficult situation now, and advances have slowed.

“So we can’t just research our way out of a problem by creating new antibiotics,” said Schaffner. “Therefore, our options for appropriate therapy become diminished.”

Schaffner said three solutions are being implemented to address the looming crisis:

The first is that physicians are taught to be more prudent in the use of antibiotics. Virtually every hospital now has an antibiotic stewardship program, which supervises the use of antibiotics, and takes corrective action if overuse is detected.

“We’re constantly making recommendations to the general population about how to shelter your cough, to encourage hand hygiene, all those things to reduce infections so we won’t have to treat,” he said.

The third is through vaccinations.

“There are clearly some vaccines that have been deployed, particularly among children, and they clearly have helped turn around antibiotic resistance in certain bacterial strains,” said Schaffner.

He pointed out the pneumococcal vaccine as one example. This vaccine prevents infection with Streptococcus pneumoniae, which can cause painful middle ear infections.

“There was an increasing development of resistance among some pneumococcal strains,” he explained. “These were included in the vaccines, and once they were deployed, the occurrence of those [resistant] strains virtually disappeared.”

Treatment Is Becoming ‘More Complicated’

Schaffner noted other pathogens that are becoming more antibiotic resistant. These include:

• E-Coli
• Enterobacter
• Acinetobacter

“These are gram-negative bacteria that can complicate the treatment of particularly very sick people who will have intravenous lines; they’re being treated with ventilators, catheters to help drain their bladders,” he said.

He added that the treatment of gonorrhea is also becoming “more complicated,” meaning that it’s harder to find drugs that work against the disease, and prescription regimes are more involved.

“The antibiotics we have are more restricted and they have to be given over a period of time,” he explained. “It’s not just one-dose treatment, and of course, compliance with treatment is not always assured, and that becomes a big problem.”

Nearly 87 percent (pdf) of patients don’t comply with doctors’ instructions for antimicrobial therapy, which increases the risk that a pathogen evolves antibiotic resistance.

He said a new threat on the national and international scene is not a bacteria, but a yeast: Candida auris, which is very drug resistant.

“It occurred around the globe in several different locations and once it gets into a hospital, it can be very vexing to try to get rid of,” said Schaffner.

Another factor is related to the increasing cost of health care in the United States, particularly surgical procedures, which forces some people to seek less expensive treatment abroad. “They can come back to this country with infections that are multidrug resistant,” Schaffner noted. “What’s over there can be over here very quickly.”

See more here theepochtimes.com

Header image: Net Doctor

About the author: George Citroner reports on health and medicine, covering topics that include cancer, infectious diseases, and neurodegenerative conditions. He was awarded the Media Orthopaedic Reporting Excellence (MORE) award in 2020 for a story on osteoporosis risk in men.

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