Antibiotic Resistance Poses Worldwide Threat, WHO Says
June 12, 2000 (Washington) -- Hoping to add a sense of urgency to the growing problem of antibiotic-resistant bacteria, the World Health Organization warned Monday that the misuse of antibiotics eventually will compromise all nations' ability to treat even minor infectious diseases, such as sore throats.
This alarming picture was painted in the WHO's annual Report on Infectious Diseases, the first report to present a comprehensive picture of the emergence of these so-called "super bugs" across the globe.
"The illusion is that science will come up with another drug. However, our options are limited," said David Heymann, MD, the WHO's chief of infectious diseases. In unveiling the report, Heymann stressed the need for a coordinated worldwide effort to stop these resistant bacteria from developing.
The problem is paradoxical. In developed nations, people often overuse antibiotics, giving any germs they may harbor an opportunity to evolve and develop resistance. In developing nations, where antibiotics are often sold without a prescription and many cannot afford a full course of medication, people often fail to complete their treatment regimens, allowing the surviving bacteria to become super bugs.
In both cases, the surviving bugs transfer their drug resistance to their next generation of bacteria -- and that means the problems of developing nations are the problems of developed nations and vice versa, CDC Director Jeffrey Koplan says. "An infectious disease can rise up in one part of the world and rapidly spread to other parts of the world," Koplan explains.
The WHO report offers several examples to illustrate the problem's magnitude. Among them are the emergence of tuberculosis strains, in Estonia, Latvia, and parts of Russia and China, that are resistant to the two most powerful TB drugs. In Thailand, there is now a strain of malaria resistant to three of the most commonly used malaria drugs, the WHO report says. And in the U.S., where antibiotics are thought to be improperly prescribed in almost one of every two cases, some 14,000 people die each year as a result of drug-resistant microbes, the report says.
Contributing to the problem is the increasing use of antibiotics to promote growth in farm animals, the WHO report says. Another problem is the use of antibiotics to treat conditions for which the drugs were not intended. For example, in the Philippines, a certain tuberculosis drug is commonly used as sort of a "lung vitamin," the report says.
There are grounds for optimism. If antibiotics can be used judiciously, resistant bugs eventually could be isolated and eliminated, Koplan says. The key is to assure that antibiotics are used at the right times and in the right places, he says.
For some diseases, there are established strategies to avoid the use of antibiotics, Heymann points out. For example, the WHO already recommends the use of vaccinations and other low-cost interventions -- including keeping tabs on where infections have broken out and where they're likely to break out -- to stop the spread of resistant germs and ensure the most effective use of antibiotics, Heymann says.