Antibiotics are the first and most potent line of defense against bacterial diseases. But their overuse and abuse in the few decades, especially to treat viruses that don't respond to antibiotics, have led to a dangerous resistance to even common infections.
The CDC has made the appropriate use of antibiotics a cornerstone of its Get Smart About Antibiotics educational campaign, now in its third year. CDC experts Lauri Hicks, DO, a medical epidemiologist, and Arjun Srinivasan, MD, associate director of infection prevention programs, spoke to WebMD about the urgency of the problem of antibiotic resistance and what can be done to reverse it.
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Hicks: Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply, causing more harm.
How long does it take to develop a resistance to an antibiotic?
Hicks: It depends on how much is being used and how often bacteria are exposed to the drug. It's related to the volume of use and the ability of bacteria to change their coat of armor. It can happen in months, it can happen in weeks, over a period of years. It usually takes longer for resistance to become widespread, but with an increase in travel, we can transport bacteria within hours to another location.
Is antibiotic resistance unique to our era?
Srinivasan: What makes this a particularly unique time in antibiotic resistance is that the pace of development of resistance is really outstripping the development of new drugs. In the past, we knew there were new drugs coming on the market -- every year we had something new. Now, we've reached a situation where that's not the case year to year. For some [germs] that we see a resistance to in hospitals, there's nothing coming anytime soon. We're facing a situation now where people are talking about the unavailability of antibiotics to treat common infections.
What could be the global consequences of antibiotic resistance?
Srinivasan: Infections became more difficult to treat, we have to use agents that are more toxic and more expensive, and we have to use them longer. The scariest situation is one we're seeing in hospitals in America, where patients are acquiring infections and there are no antibiotic options. We have a disease that should be treatable and we now encounter situations where they are not treatable. In some cases, it's taking us back to the pre-antibiotic period.
In which patient populations is antibiotic resistance the greatest?
Hicks: We're seeing resistance among all age groups. When we look at surveillance data for certain infections like streptococcus that cause meningitis, pneumonia, and bloodstream infections, the frequency of those infections has increased over time. We're seeing a rise in antibiotic resistance for all age groups and for a number of different bacteria.