It’s good to see antibiotic resistance as today’s “Buzz in the Blogosphere.” Ironically, this weekend I had started putting together a post about how this issue isn’t given the attention it deserves.
Antibiotic resistance is a silent plague: the CDC estimates that 14,000 people per year in the U.S. die from hospital-acquired resistant bacterial infections–this figure doesn’t include resistant infections acquired outside the hospital. These figures are certainly underestimates because the mortality due to hospital-acquired infections is dramatically underreported. Also, the reporting of antibiotic resistance is often spotty (how hospitals actually report infections is a whole separate post).
Essentially, in the U.S., we’re talking about mortality equivalent to that of the AIDS epidemic, if not greater. In the developing world, antibiotic resistance creates its own problems. If a cheap, generic antibiotic doesn’t work, that can be a death sentence. Likewise, a doctor will often get one chance to treat a patient: treatment failure due to resistance is lethal.
Mortality isn’t the only cost. There is a huge economic cost of antibiotic resistance. Everything from the length of hospital stays to the cost of treatment increases when the infection is resistant, even if it can ultimately be treated.
Finally, one other point. We tend to focus on the sexy diseases like TB, AIDS, and malaria. None of these are the top killer of children in the developing world. What is? Bacterial pneumonia (mostly Streptococcus pneumoniae). When it works, penicillin is remarkably effective and cheap. Unfortunately, penicillin resistance is rising to the point where it is no longer effective (some recent, unpublished data from Southern Africa that I saw put penicillin resistance at roughly 70%). This means newer, more expensive drugs have to be used, and death is more likely (one point to remember with severe infections is that time is of the essence–repeated treatment failure is not an option).
Antibiotic resistance doesn’t have sexy movie stars attached to it–you’re stuck with the Mad Biologist–but that doesn’t make it any less important.