Antibiotic resistance: fact or fiction?

Antibiotic resistance is a major threat to public health, according to the World Health Organization (WHO). This is not a future problem, or a third world problem, it is current and can affect anyone in the world. Age is not a factor. We will discuss this new report from the WHO. WHO’s first global report on antibiotic resistance reveals a serious, worldwide threat to public health.(1)

Antibiotics are losing their ability to treat infections in every country in the world, and this state of affairs could have disturbing consequences for public health. Diseases that we thought were defunct could come back full force as global killers. The report explores antimicrobial resistance, including antibiotic resistance.“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.” — Dr. Keiji Fukuda, WHO’s Assistant Director-General for Health Security.(1) To view a PDF of Antimicrobial Resistance: Global Report on surveillance 2014,(2) click here. The WHO report is the first to gather extensive data from the WHO on antibiotic resistance and has information from 114 countries.(3) Although the data is more complete in some regions than in others, it is apparent that drug-resistant strains of bacteria and viruses are common. Attempting to insure the efficacy of the antibiotics currently in use is a no-win situation.

The report focuses on antibiotic resistance in seven bacteria that are responsible for common and potentially serious diseases, such as bloodstream infections (sepsis), diarrhea, pneumonia, urinary tract infections, and gonorrhea. Resistance was also found to antibiotics that are used as a last resort against life-threatening infections, such as that caused by a common intestinal bacterium, Klebsiella pneumoniae.(3) Antibiotics become resistant and lose their effect because the microbe itself changes, by either mutating or obtaining genetic information from other microbes to develop resistance.(3) The report states that regarding surveillance, the gaps are greatest where health systems are weak. The vision is “To achieve a monitoring capacity that will capture the global situation of antimicrobial resistance, and inform decision-making.”(4) The WHO encourages standards for global surveillance and a collaborative platform for surveillance. Commitment from stakeholders and comprehensive national plans are needed to protect us in the future. Surveillance is crucial to inform public health actions and strategies. In January 2014, the WHO Executive Board approved a draft resolution co-sponsored by several Member States: “Combating antimicrobial resistance, including antibiotic resistance.”

What can we do?

A common problem, and one we can help to alleviate, is antibiotic overuse. Some patients do not understand that an antibiotic is not indicated for a common cold, caused by a virus, or for a viral upper respiratory infection. We can effectively communicate why the decision not to prescribe an antibiotic is made in certain instances. Recommending symptomatic relief can be helpful, and the Center for Disease Control and Prevention’s (CDC's) downloadable symptomatic prescription pad is handy for this purpose.(6)

To view a PDF of the CDC's symptomatic prescripton pad,(6) click here.

Discuss potential side effects of antibiotic use, including adverse events and resistance, as many individuals do not realize that antibiotics can be harmful.

We can do our job by educating our patients and the public. Numerous fact sheets are available to help us spread the message about antibiotic overuse and resistance.(7) Help spread the word!

To view a PDF about antibiotics and viral infections, click here.

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